The clinical characteristics of posterior reversible encephalopathy syndrome in patients with systemic lupus erythematosus
10.3760/cma.j.issn.1007-7480.2009.09.010
- VernacularTitle:系统性红斑狼疮合并脑后部可逆性脑病综合征的临床分析
- Author:
Hua SHUI
;
Qun WANG
;
Xiaoyun SI
;
Xiaoyan WU
- Publication Type:Journal Article
- Keywords:
Lupus erythematosus,systemic;
Hyper tension;
Posterior reversible encephalopathy syndrome
- From:
Chinese Journal of Rheumatology
2009;13(9):620-623
- CountryChina
- Language:Chinese
-
Abstract:
Objective Posterior reversible encephalopathy syndrome (PRES) is a rapidly evolving neurologic syndrome with characteristic clinical and radiographic features. To define the clinical characteristics of PRES in patients with eoneomitant systemic lupus erythematosus (SLE) by analyzing their clinical manif-estations and reviewing the literature. Methods The details of 4 cases and a review of the literature relevant to the development of PRES in association with SLE are presented. We described the clinical and imaging characteristics and associated risk factors of posterior roversible PRES in patients with SLE. Results Inclu-ding our cases, we reviewed a total of 48 patients with SLE and PRES. Hypertension was observed in 42 cases (88%), renal failure in 30 cases (63%), 39 recent onset cases were treated with immunosuppressive drugs and/or steroids recently (81%). Headache was observed in 46 cases (96%), Corffusion/coma in 20 cases (42%), seizures in 43 cases (90%), visual disturbances in 28 cases (58%). Neuroimaging demonstrated posterior white matter edema involving the parietal-occipital, temporal, frontal lobes, and cerebellum. The hypertension and other worsening factors should be treated. Conclusion PRES is a central nervous system syndrome that is observed in SLE patients. It is associated mainly to acute hypertension, renal failure, and immunosuppressive drugs. Although reversibility is common, residual neurological damage may be observed. Complete clinical and radiographic recovery oeeurrs with prompt antihypertensive treatment and supportive care.
