BackgroundPosterior reversible encephalopathy syndrome (PRES) is known as a transfusion‐related complication with typically favorable prognosis and no report fatalities. Pathological evaluation of PRES is also scarce.Case ReportAn 88‐year‐old female with myelodysplastic syndromes (MDS) attended our hospital because of a compression fracture and chronic heart failure with chronic anemia. While her hemoglobin levels improved from 4.6 to 8.0 g/dL and the pleural effusions substantially decreased following six units of red blood cell transfusion and diuretic therapy, a gradual decline in cognitive function and speech reduction was noted. PRES was diagnosed by magnetic resonance imaging of the head. Despite treatment of intensive supportive care, the patient fell into a coma by the 20th day and passed away on the 22nd day. Although the pathophysiological link between blood‐transfusion‐related PRES and its impact on survival is not fully understood, autopsy findings confirmed the diagnosis of PRES and revealed multiple cerebral hemorrhages that were not detected in earlier imaging studies.ConclusionThis case highlights the importance of vigilant monitoring and management of PRES, especially in high‐risk populations such as elderly patients with multiple comorbidities or those with thrombocytopenia. Further studies are needed to elucidate the mechanisms of PRES in patients with hematologic diseases.

中文翻译：

---

骨髓增生异常综合征患者输血后致死性可逆性后部脑病综合征


背景可逆性后部脑病综合征（PRES）被认为是一种与输血相关的并发症，通常预后良好，并且没有死亡报告。 PRES的病理学评估也很少。病例报告一名88岁女性，患有骨髓增生异常综合征（MDS），因压缩性骨折和慢性心力衰竭伴慢性贫血就诊于我院。虽然经过六个单位的红细胞输注和利尿治疗后，她的血红蛋白水平从 4.6 g/dL 改善至 8.0 g/dL，并且胸腔积液大幅减少，但认知功能逐渐下降，言语能力下降。 PRES 是通过头部磁共振成像诊断的。尽管接受了重症支持治疗，患者在第20天仍陷入昏迷，并于第22天去世。尽管输血相关的 PRES 及其对生存的影响之间的病理生理学联系尚未完全清楚，但尸检结果证实了 PRES 的诊断，并揭示了早期影像学研究中未检测到的多发性脑出血。结论该病例强调了警惕监测的重要性PRES 的管理和管理，特别是在高危人群中，例如患有多种合并症的老年患者或患有血小板减少症的患者。需要进一步的研究来阐明 PRES 在血液系统疾病患者中的作用机制。