ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2018, Vol. 27 ›› Issue (5): 418-423.DOI: 10.3969/j.issn.1006-298X.2018.05.004

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Characteristics of posterior reversible encephalopathy syndrome associated with systemic lupus erythematosus

  

  • Online:2018-10-28 Published:2018-11-14

Abstract:

Objective:To explore the clinical features,treatment and prognosis of systemic lupus erythematosus (SLE) patients with posterior reversible encephalopathy syndrome (PRES).
Methodology:Sixteen SLE patients with PRES were enrolled into this retrospective studyTheir pathogenesis,risk factors,treatment and prognosis were investigated.
Results:They were 14 female and 2 male with a mean age of (228±85) years old(ranged from 9 to 43).All 16 cases had high systemic activity,the mean SLEDAI score was (209±37).15 cases(938%) had hypertension,12 cases(75%) had renal insufficiency,low lymphocyte count,dyslipidemia,and all of cases(100%) used hormones or immunosuppressants.Clinical manifestations included seizures in 16 (100%),headache in 5 (31%),visual disturbances in 5 (31%),and nausea and vomiting in 6 (38%).CT and magnetic resonance imaging (MRI) showed that the lesions were mostly located in bilateral parietooccipital lobes.Temporal lobes,frontal lobes,ventricles,basal ganglia,cerebellum,and cortex may also be involved in.Antihypertensive,antiepileptic and lowdose glucocorticoids  relieve symptoms.
Conclusion:SLE patients with PRES is a clinicalimaging syndrome,which often associated with hypertension,renal insufficiency and systemic disease activity.Clinical manifestations include headache,visual disturbances,seizures,nausea and vomiting.Brain imaging manifests as subcortical vasogenic edema in the bilateral parietooccipital area.Early diagnosis and treatment generally predicates good prognosis.

Key words: systemic lupus erythematosus, posterior reversible encephalopathy syndrome, image