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World J Anesthesiol. Sep 22, 2026; 14(1): 123553
Published online Sep 22, 2026. doi: 10.5313/wja.123553
Published online Sep 22, 2026. doi: 10.5313/wja.123553
Fulminant postpartum posterior reversible encephalopathy syndrome associated with hemolysis, elevated liver enzymes, and low platelet count syndrome: A case report
Federica Merciai, Tommaso Pagano, Massimo Petrosino, Aniello Erra, Daniele Scarano, Raffaele Muoio, Domenico Carbone, Department of Anesthesia and Intensive Care, "Umberto I" Hospital, Nocera Inferiore 84014, Campania, Italy
Author contributions: Merciai F and Pagano T contributed to the manuscript's writing and editing, and to data analysis; Petrosino M and Erra A contributed to the data collection; Scarano D, Muoio R, and Carbone D contributed to the study's conceptualization and supervision; and all authors read and approved the final manuscript.
AI contribution statement: The authors declare that no AI tools were used for this manuscript and take full responsibility for the accuracy of the review, confidentiality of the manuscript, and ethical integrity of this case report.
Informed consent statement: An informed consent was obtained for the publication of this case.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Federica Merciai, MD, Department of Anesthesia and Intensive Care, "Umberto I" Hospital, St. Alfonso De Nicola, Nocera Inferiore 84014, Campania, Italy.
Received: June 9, 2026
Revised: July 15, 2026
Accepted: August 10, 2026
Published online: September 22, 2026
Processing time: 105 Days and 18 Hours
Revised: July 15, 2026
Accepted: August 10, 2026
Published online: September 22, 2026
Processing time: 105 Days and 18 Hours
Core Tip
Core Tip: This report describes a rare and catastrophic postpartum case of posterior reversible encephalopathy syndrome (PRES) associated with hemolysis, elevated liver enzymes, and low platelet count syndrome and eclampsia complicated by hemorrhagic transformation, diffuse cerebral edema, and brain death. The case highlights that PRES is not invariably reversible and emphasizes the prognostic role of atypical magnetic resonance imaging findings, intracranial hemorrhage, and severe endothelial dysfunction.