title: [Reversible posterior leukoencephalopathy syndrome in a patient presenting granulomatosis with polyangiitis].
abstract: BACKGROUND
  Reversible posterior leukoencephalopathy syndrome (RPLS) is characterised by clinical neurological features of sudden onset and brain MRI findings such as T2/Flair white matter hyperintensities. RPLS can occur in autoimmune diseases, and rarely in systemic vasculitis. We report a case of RPLS in a woman presenting granulomatosis with polyangiitis (Wegener's granulomatosis).
  
  
  METHODS
  A 22-year-old female patient was treated with methylprednisolone pulses for granulomatosis with polyangiitis and neurological impairment. A few hours after the second pulse, the patient had seizures, blindness and confusion associated with high blood pressure and acute renal failure. MRI revealed a high-intensity area on T2-Flair weighted images of the occipital-temporal lobes. The patient was treated with antiepileptic and antihypertensive medications, oral steroids and cyclophosphamide; the clinical and radiological findings proved reversible over the ensuing days.
  
  
  CONCLUSIONS
  The occurrence of RPLS in systemic vasculitis is rare. Six cases of RPLS associated with granulomatosis and polyangiitis have been reported. It appears important to screen for high blood pressure in patients recently treated with corticosteroids for vasculitis as this condition may represent a precipitating factor for RPLS.
authors: Service de dermatologie, université François-Rabelais, CHU de Tours, avenue de la République, 37170 Chambray-Les-Tours, France. Electronic address: laura.chaput@wanadoo.fr.
authors: L
authors: L
authors: Chaput
authors: Service de néphrologie, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
authors: N
authors: N
authors: Rabot
authors: Service de neurologie, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
authors: N
authors: N
authors: Limousin
authors: Service de neuroradiologie, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
authors: J-P
authors: JP
authors: Cottier
authors: Service de médecine interne, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
authors: B
authors: B
authors: Lioger
authors: Service de dermatologie, université François-Rabelais, CHU de Tours, avenue de la République, 37170 Chambray-Les-Tours, France; BIP, ISP 1282 INRA, université de Tours, 37000 Tours, France.
authors: M
authors: M
authors: Samimi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D009460:Neurologic Examination / Q000187:drug effects; D054038:Posterior Leukoencephalopathy Syndrome / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy; D012307:Risk Factors; D066127:White Matter / Q000187:drug effects / Q000473:pathology; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000927:Anticonvulsants; D000959:Antihypertensive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone
keywords: Granulomatose avec polyangéite; Granulomatosis with polyangiitis; Posterior reversible encephalopathy syndrome; Syndrome d’encéphalopathie postérieure reversible; Systemic vasculitis; Vascularite