Posterior reversible encephalopathy syndrome: an acute manifestation of systemic lupus erythematous.
Stroke mimickers are common, and they represent a diagnostic dilemma for clinicians. Many, like posterior reversible encephalopathy syndrome (PRES), are easily reversible. The manifestation of PRES is characterised by headaches, convulsions, altered mental functioning and blindness. In most cases, computed tomography of the brain will show hypodense lesions in the parieto-occpitial lobe, which only further confounds the physician. Although this syndrome is uncommon, prompt and accurate recognition allows early treatment, which has been shown to produce favourable outcomes. Herein, we report the case of a 54-year-old woman, who presented with PRES, as an acute manifestation of systemic lupus erythematous (SLE) and lupus nephritis. The patient was initially thought to be experiencing an ischaemic stroke, but the diagnosis was later changed. On management of her underlying condition, her symptoms resolved. PRES should be recognised as an acute emergency manifestation of SLE. It should not be mistaken for an ischaemic stroke as inappropriate treatment could have adverse outcomes.
Austin Health, 145 Studley Road, PO Box 5555, Heidelberg, Victoria 3084, Australia. dexter.chan@mohh.com.sg.
Dexter Yak Seng
DY
Chan
Yin Sheng
YS
Ong
D000208:Acute Disease; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis* / Q000209:etiology; D014057:Tomography, X-Ray Computed