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KMID : 0388220130200020103
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Journal of the Korean Rheumatism Association
2013 Volume.20 No. 2 p.103 ~ p.107
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Cyclophosphamide-induced Posterior Reversible Encephalopathy Syndrome in a Patient with Lupus Nephritis
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Lee Chang-Hoon
Lee Yu-Min
Ahn Seon-Ho
Song Ju-Hung
Lee Myeung-Su
Ryu Dae-Woong
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Abstract
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Posterior reversible encephalopathy syndrome (PRES) is a neurologic condition characterized by vasogenic edema on neuroimaging and is associated with the setting of severe hypertension, eclampsia, autoimmune disease, malignancy, and immunosuppressive drugs. We report on a 42 year-old female systemic lupus erythematous patient who presented altered consciousness, seizure, and visual disturbance after cyclophosphamide pulse therapy. Magnetic resonance imaging (MRI) showed multi-focal high signal intensity lesions in the parieto-occipital cortex bilaterally and in the subcortical white matter. Her condition was improved and her MRI lesions were resolved after aggressive blood pressure control and high-dose steroid treatment. It is possibly the first reported case of PRES in a patient with lupus, treated with cyclophosphamide pulse therapy during a nephritis flare in Korea.
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KEYWORD
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Posterior reversible encephalopathy syndrome, Systemic lupus erythematosus, Cyclophosphamide
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