Authors :
Dr. Ashruti Agrawal; Dr. Bhamidipaty Kanaka Durga Prasad; Dr. Kesinakurthi Satish Kumar; Dr. Tallapaneni Kiran
Volume/Issue :
Volume 10 - 2025, Issue 6 - June
Google Scholar :
https://tinyurl.com/yc58w9kj
DOI :
https://doi.org/10.38124/ijisrt/25jun863
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Posterior reversible encephalopathy syndrome (PRES) is a rare, potentially reversible clinico-radiological
condition affecting a small percentage of patients with systemic lupus erythematosus (SLE). This case report describes a 26-
year-old female with SLE and type IV lupus nephritis who presented with seizures, altered sensorium, and hypertension.
MRI revealed bilateral symmetrical T2/FLAIR hyperintensities in multiple brain regions, confirming PRES. Despite
intensive management, including antihypertensive and anticonvulsant therapy and extraventricular drain placement for
hydrocephalus, the patient developed multiorgan dysfunction and succumbed following cardiac arrest. This case
underscores the importance of considering PRES in young females with SLE presenting with neurological symptoms and
highlights the need for prompt radiological diagnosis and management to prevent irreversible damage or death.
Keywords :
Hypertension; Lupus Nephritis; Posterior Reversible Encephalopathy Syndrome.
References :
- Liu B, Zhang X, Zhang FC, et al. Posterior reversible encephalopathy syndrome could be an underestimated variant of “reversible neurological deficits” in systemic lupus erythematosus. BMC Neurol. 2012;12:152. doi:10.1186/1471-2377-12-152.
- Mikdashi J, Nived O. Measuring disease activity in adults with systemic lupus erythematosus: the challenges of administrative burden and responsiveness to patient concerns in clinical research. Arthritis Res Ther. 2015;17:1-10. doi:10.1186/s13075-015-0702-6.
- Merayo-Chalico J, Barragán-Martínez C, Rodríguez-Jiménez P, et al. Clinical outcomes and risk factors for posterior reversible encephalopathy syndrome in systemic lupus erythematosus: a multicentric case–control study. J Neurol Neurosurg Psychiatry. 2016;87(3):287-94. doi:10.1136/jnnp-2014-310404.
- Vaysman T, Xu P, Vartanian T, et al. “Highlighting” red nuclei by atypical posterior reversible encephalopathy syndrome in a patient with systemic lupus erythematosus. Clin Case Rep. 2019;7(7):1404-8. doi:10.1002/ccr3.2247.
- Hinchey J, Chaves C, Appignani B, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996;334(8):494-500. doi:10.1056/NEJM199602223340803.
- Ellis CA, McClelland AC, Mohan S, et al. Cerebrospinal fluid in posterior reversible encephalopathy syndrome: implications of elevated protein and pleocytosis. Neurohospitalist. 2019;9(2):58-64. doi:10.1177/1941874418802061.
- Afilal I, Nasri S, Bendaoud M, et al. Fatal outcome of posterior reversible encephalopathy syndrome (PRES) in a lupus nephropathy patient: a case report. Radiol Case Rep. 2022;17(6):2215-9. doi:10.1016/j.radcr.2022.03.084.
- Thust SC, Burke C, Siddiqui A. Neuroimaging findings in sickle cell disease. Br J Radiol. 2014;87(1040):20130699. doi:10.1259/bjr.20130699.
- Kwon S, Koo J, Lee S. Clinical spectrum of reversible posterior leukoencephalopathy syndrome. Pediatr Neurol. 2001;24(5):361-364. doi:10.1016/S0887-8994(01)00265-X.
- Antunes NL, Small TN, George D, et al. Posterior leukoencephalopathy syndrome may not be reversible. Pediatr Neurol. 1999;20(3):241-3. doi:10.1016/S0887-8994(98)00244-2.
Posterior reversible encephalopathy syndrome (PRES) is a rare, potentially reversible clinico-radiological
condition affecting a small percentage of patients with systemic lupus erythematosus (SLE). This case report describes a 26-
year-old female with SLE and type IV lupus nephritis who presented with seizures, altered sensorium, and hypertension.
MRI revealed bilateral symmetrical T2/FLAIR hyperintensities in multiple brain regions, confirming PRES. Despite
intensive management, including antihypertensive and anticonvulsant therapy and extraventricular drain placement for
hydrocephalus, the patient developed multiorgan dysfunction and succumbed following cardiac arrest. This case
underscores the importance of considering PRES in young females with SLE presenting with neurological symptoms and
highlights the need for prompt radiological diagnosis and management to prevent irreversible damage or death.
Keywords :
Hypertension; Lupus Nephritis; Posterior Reversible Encephalopathy Syndrome.