Posterior reversible encephalopathy syndrome as a complication of acute lupus activity.
OBJECTIVE
We aimed to describe the clinical and imaging characteristics; associated risk factors and neurological outcome of posterior reversible encephalopathy syndrome (PRES) in patients with systemic lupus erythematosus (SLE).


METHODS
From October 2001 to January 2007, we identified patients with SLE and the criteria for PRES in our institution, which is a tertiary-care referral center for patients with SLE; the patients were evaluated at baseline and followed to determine the clinical outcome.


RESULTS
We identified 22 episodes of PRES in 21 patients; 20 (95.2%) were women, mean age of onset was 24.9+/-8.6 years, all patients had high systemic activity (SLEDAI scores from 12 to 39). Acute hypertension was observed in 18 episodes (81.8%), and renal failure in 16 (72.7%); only 3 patients were on cyclophosphamide at the time of the onset of PRES. Persistent neurological deficit was observed in 2 cases; one patient died during the acute episode.


CONCLUSIONS
PRES is a central nervous system syndrome that is observed in SLE patients. It was associated mainly to high systemic activity, acute hypertension, and renal failure. Although reversibility is common, residual neurological damage may be observed.
Baizabal-Carvallo
José Fidel
JF
Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, México City, Mexico. baicarjf@hotmail.com
Barragán-Campos
Héctor Manuel
HM
Padilla-Aranda
Héctor Javier
HJ
Alonso-Juarez
Marlene
M
Estañol
Bruno
B
Cantú-Brito
Carlos
C
García-Ramos
Guillermo
G
D000328:Adult; D001928:Brain Diseases, Metabolic / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D051437:Renal Insufficiency / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
D003520:Cyclophosphamide