Posterior reversible encephalopathy syndrome as the first presentation of a connective tissue disorder: A case report

Abstract

Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical-radiological diagnosis. Although hypertension is the main cause of this condition several secondary causes have been identified. Here we discuss a 53-year-old woman with a history of hypertension who presented with sudden onset of headache, seizures, and bilateral cortical blindness. MRI was suggestive of PRES. She had minimal blood pressure fluctuations. Antinuclear antibodies were significantly positive and a history of symmetrical polyarthritis was revealed. As the criteria for a particular connective tissue disorder were not fulfilled, the diagnosis of an undifferentiated connective tissue disease was made. In the presence of classical symptoms and imaging, PRES should be suspected even amongst patients without blood pressure fluctuations. Secondary causes should be identified and corrected in such patients.