Posterior Reversible Encephalopathy Syndrome in Systemic Lupus Erythematosus
Open Access
- 15 May 2011
- journal article
- Published by The Journal of Rheumatology in The Journal of Rheumatology
- Vol. 38 (8), 1607-1611
- https://doi.org/10.3899/jrheum.101308
Abstract
Objective. To study the clinical profile of posterior reversible encephalopathy syndrome (PRES) in patients with systemic lupus erythematosus (SLE) and analyze the risk factors and outcomes associated with it. Methods. We identified patients with SLE and PRES from January 2006 to October 2010. Data were collected on demographic details, lupus characteristics, PRES-related features, laboratory abnormalities, treatment details, and outcomes. Results. We studied 13 patients (all female) ages 14–37 years (median 23 yrs; 4 were aged < 18 yrs with juvenile SLE). Duration of lupus ranged from 1.5 to 36 months (median 6 mo). Six patients had PRES as a part of their initial presentation of lupus. All had active lupus and hypertension; 9 had nephritis. Four patients were on treatment with cyclophosphamide therapy when they developed PRES. Antihypertensives and antiepileptics were the mainstay of treatment along with supportive care. Immunosuppressive therapy was guided by lupus-related major organ manifestations. Two patients had focal neurological deficits; one had persistent hemiparesis at followup. One patient died. Conclusion. PRES occurs in young lupus patients and in the early part of the disease. Focal deficits are not uncommon. It can be the presenting manifestation of lupus. Management is predominantly symptomatic. Immunosuppression is directed by other major organ manifestations. Early diagnosis and appropriate management is productive.Keywords
This publication has 20 references indexed in Scilit:
- SLE disease patterns in a Danish population-based lupus cohort: an 8-year prospective studyLupus, 2009
- Posterior reversible encephalopathy syndrome as a complication of acute lupus activityClinical Neurology and Neurosurgery, 2009
- Posterior Reversible Encephalopathy Syndrome, Part 2: Controversies Surrounding Pathophysiology of Vasogenic EdemaAmerican Journal Of Neuroradiology, 2008
- Understanding the pathogenesis of ANCA: where are we today?Cleveland Clinic Journal of Medicine, 2002
- Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosusArthritis & Rheumatism, 1997
- A Reversible Posterior Leukoencephalopathy SyndromeNew England Journal of Medicine, 1996
- Spin‐spin relaxation of brain tissues in systemic lupus erythematosusArthritis & Rheumatism, 1995
- Cyclosporine NeurotoxicityNew England Journal of Medicine, 1991
- Magnetic resonance and computed tomographic imaging in the evaluation of acute neuropsychiatric disease in systemic lupus erythematosus.Annals Of The Rheumatic Diseases, 1989
- MR imaging of systemic lupus erythematosus involving the brainAmerican Journal of Roentgenology, 1985