Journal of Clinical Case Reports

Posterior Reversible Encephalopathy Syndrome (PRES) as an Initial Presentation of Systemic Lupus Erythematosus (SLE)

Abstract

Babu Philip, Sandhya Limaye, Thanakrishnan G and Arun Aggarwal

Background: Posterior Reversible Encephalopathy Syndrome (PRES) refers to a clinico-radiological syndrome characterized by headache, altered mental function, visual disturbance, seizures and transient posterior changes on neuro-imaging. Case report: We present a case of a 38 year old female who presented with sudden onset behavioural change, visual disturbance and subsequent witnessed generalized tonic-clonic seizure. A cerebral MRI showed extensive signal abnormality consistent with vasogenic oedema in the cerebellar hemispheres and subcortical white matter of the occipito-parietal lobes consistent with a neuro-radiological diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES). Conclusion: We describe a case of a dramatic first presentation of Systemic Lupus Erythematosus (SLE) with neurological manifestations of PRES, occurring in the absence of accompanying evidence of lupus nephritis, cerebritis or other usual causative factors, such as immunosuppression.