Posterior reversible encephalopathic syndrome in systemic lupus erythematous: A case report

Abstract

Posterior reversible encephalopathy syndrome (PRES) implies to a reversible subcortical vasogenic brain edema, which leads to some acute neurological symptoms. PRES occurs usually in the setting of renal failure, blood pressure fluctuations, cytotoxic drugs, autoimmune disorders, and pre-eclampsia or eclampsia.This is a 40 year old female patient with history of systemic lupus erythematous (SLE) from twenty years ago, admitted to our neurology ward due to severe and refractory headache with multiple convulsive events.Brain MRI showed vasogenic brain edema in occipito-parieto-frontal lobes white matter compatible with PRES. Treatment is omitting of the etiology, but in these patients, discontinuation of immunosuppressive drugs is not possible and probably intravenous methylprednisolone pulse is a good treatment option especially in patient without response to aggressive control of blood pressure.