title: Posterior reversible encephalopathy syndrome could be an underestimated variant of "reversible neurological deficits" in Systemic Lupus Erythematosus.
abstract: BACKGROUND
  Posterior reversible encephalopathy syndrome (PRES) has been increasingly identified in patients with systemic lupus erythematosus (SLE) owing to the advance in neuroimaging techniques. Prompt diagnosis is pivotal to improve its outcome. To analyze the clinical and radiographic profile of PRES in patients with SLE and search for the appropriate treatment strategy PRES in SLE.
  
  
  METHODS
  SLE patients who fulfilled the diagnostic criteria for PRES from August 2008 to January 2011 were evaluated at baseline, and followed to determine clinical outcomes. Data were analysis on clinical characteristics, laboratory abnormalities, treatment details, and outcomes.
  
  
  RESULTS
  Ten episodes of PRES in patients with SLE were identified. All patients were female, mean age of onset was 22.93 ± 2.48 years, and SLEDAI at the onset of PRES were 25.8 ± 5.7. All cases had acute onset of headache, altered mental status, stupor, vomiting, cortical blindness and seizures. Neurological symptoms were the initial manifestation of SLE in three cases. Head magnetic resonance imaging (MRI) demonstrated posterior white matter edema involving the parietal, temporal and occipital lobes, which were more conspicuous on T2 weighted spin echo and diffusion-weighted MR imaging (DWI) than on computed tomography (CT) scan. Complete clinical and radiographic recovery was observed in 8 patients after prompt treatment with corticosteroids.
  
  
  CONCLUSIONS
  PRES might be due to lupus per se besides other traditional causative factors such as hypertension. PRES might be an underestimated variant of "reversible neurological deficits" in SLE. Prompt recognition and timely management is important to prevent permanent neurological deficits.
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.forename: Xuan
authors.initials: X
authors.lastname: Zhang
authors.forename: Feng-Chun
authors.initials: FC
authors.lastname: Zhang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yao
authors.forename: Ri-Zhi
authors.initials: RZ
authors.lastname: Zhou
authors.forename: Miao-Miao
authors.initials: MM
authors.lastname: Xin
authors.forename: Li-Qin
authors.initials: LQ
authors.lastname: Wang
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D054038:Posterior Leukoencephalopathy Syndrome / Q000150:complications* / Q000473:pathology