The spectrum of posterior reversible encephalopathy in systemic lupus erythematosus.

Journal: Clinical rheumatology

Volume: 34

Issue: 12

Year of Publication: 2016

Affiliated Institutions:  Department of Rheumatology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, Durban, South Africa. Department of Rheumatology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, Durban, South Africa. modyg@ukzn.ac.za.

Abstract summary 

Our aim was to compare our South African cohort of systemic lupus erythematosus (SLE) and posterior reversible encephalopathy syndrome (PRES) with other published series. We reviewed the records of 10 patients with SLE and PRES seen over a 10-year period and their demographic data, clinical manifestations, laboratory tests, imaging findings, and outcome were recorded. We identified 10 females who included six Indians, three mixed ethnicity, and one African Black. Three patients had PRES at the onset of SLE. The most common manifestations at presentation were seizures (100 %), hypertension (80 %), and altered mental state (50 %). On neuroimaging, nine patients had bilateral involvement, and the occipital (90 %), parietal (90 %), and frontal lobes (50 %) were most commonly involved. The risk factors for PRES were disease activity (90 %), renal disease (80 %) and hypertension (80 %). Ninety percent of the patients were on immunosuppressive therapy. Immunosuppressive therapy was increased in six patients (60 %), continued in two and reduced in two patients after the diagnosis of PRES. Seven patients recovered completely and three patients died from co-morbidities. A review of the larger case series of SLE and PRES showed that the presentation and neuroimaging findings were similar; most patients had active disease at the time of PRES and the majority of patients required intensification of immunosuppressive therapy. We have shown that the majority of patients with SLE have active disease at the time of PRES, and they require an increase in their immunosuppressive therapy.

Authors & Co-authors:  Budhoo Amritha A Mody Girish M GM

Study Outcome 

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Statistics
Citations :  Arthritis Rheum. 1997 Sep;40(9):1725
Authors :  2
Identifiers
Doi : 10.1007/s10067-015-3055-2
SSN : 1434-9949
Study Population
Females
Mesh Terms
Adolescent
Other Terms
Asians;Disease activity;Ethnicity;Immunosuppressive drugs;Posterior reversible encephalopathy syndrome;Systemic lupus erythematosus
Study Design
Cohort Study,Case Study,Cross Sectional Study
Study Approach
Mixed Methods,Systemic Review
Country of Study
South Africa
Publication Country
Germany