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Systemic lupus erythematosus complicated with posterior reversible encephalopathy syndrome and intracranial vasculopathy
Author(s) -
CHEN HungAn,
LIN YeongJang,
CHEN PeiChih,
CHEN TaiYuan,
LIN KaoChang,
CHENG HeHsiung
Publication year - 2010
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/j.1756-185x.2010.01545.x
Subject(s) - medicine , posterior reversible encephalopathy syndrome , antiphospholipid syndrome , headaches , neuroimaging , eclampsia , subarachnoid hemorrhage , vasculitis , fulminant , encephalopathy , pathology , magnetic resonance imaging , radiology , surgery , thrombosis , biology , pregnancy , genetics , disease , psychiatry
Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition characterized by reversible vasogenic edema on neuroimaging. It is associated with various neurological manifestations, including headaches, vomiting, seizures, visual loss, altered mental status and focal neurological deficits. PRES mainly occurs in the setting of eclampsia, hypertension, uremia, malignancy, transplantation, autoimmune diseases and/or use of immunosuppressive drugs. This syndrome has been described in patients with systemic lupus erythematosus (SLE). PRES is a potentially reversible clinical–radiological entity; however, it can be complicated with vasculopathy, infarction or hemorrhage. Vasculopathy has been demonstrated to be a common finding in patients with SLE. We report the case of a woman with lupus nephritis and PRES whose diffuse vasculopathy was present on initial neuroimaging. Subsequent brain computed tomography scan demonstrated interval development of intraparenchymal hemorrhage and subarachnoid hemorrhage. To our knowledge, this unique brain image pattern has not been reported in SLE patients.