Reversible posterior leukoencephalopathy syndrome (RPLS) in a patient with systemic lupus erythematosus (SLE) and lupus nephritis

Zar, Tausif; Samson, Wilner; Palmisano, Joseph

doi:10.1093/ndt/gfm278

Cited by 8 publications

(4 citation statements)

References 3 publications

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“…27,71,106-108 However, there were also rare reports that PRES developed after steroid use. 109,110 Therefore, the value of corticosteroids in PRES treatment is still controversial. As PRES has become a common entity, it is the appropriate time to conduct controlled trials to test the efficacy of a variety of medications, including corticosteroids, magnesium sulfate, and antiepileptic medications.…”

Section: Treatment In Presmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome: Clinicoradiological Spectrum and Therapeutic Strategies

Jenny

Castaldo

2012

Hospital Practice

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Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome of encephalopathy, headache, visual disturbance, and seizures. In most cases, symptoms present acutely or subacutely in the setting of accelerated hypertension, eclampsia, autoimmune disease, immunosuppressive treatment, or cancer chemotherapy. One essential feature of PRES is the presence of reversible cerebral vasogenic edema that has a predominantly posterior distribution on brain imaging. Atypical imaging features are commonly described, including involvement of the anterior brain or brainstem and the coexistence of ischemia or hemorrhage. In most cases, both clinical and radiological findings are reversible, although permanent imaging abnormalities and residual neurological sequelae can be seen in a minority of patients. The syndrome is thought to be caused by a breakdown of the blood-brain barrier and an extravasation of the intravascular fluid. Treatment of hypertension and seizures, and withdrawal of causative agents are the mainstays of therapy in PRES.

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Section: Treatment In Presmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome: Clinicoradiological Spectrum and Therapeutic Strategies

Jenny

Castaldo

2012

Hospital Practice

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“…The association between steroid use and the development of RPLS is elusive since steroids are frequently used concomitantly with other medications, including cyclosporine (1,4,(22)(23)(24) to treat underlying diseases, such as renal failure or connective tissue diseases, which may also lead to RPLS (22,25). Thus, the contribution of steroid therapy to RPLS remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Reversible Posterior Leukoencephalopathy Syndrome Associated with Treatment for Acute Exacerbation of Ulcerative Colitis

et al. 2016

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Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinical syndrome of varying etiologies with similar neuroimaging findings. This is a case report of a 25-year-old woman who developed typical, neurological symptoms and magnetic resonance imaging abnormalities after treatment for the acute exacerbation of ulcerative colitis (UC), which included blood transfusion, the systemic administration of prednisolone, and the administration of metronidazole. It has been reported that these treatments may contribute to the development of RPLS. RPLS should therefore be considered in the differential diagnosis of UC patients who exhibit impaired consciousness, seizures or visual deficits during treatment. We report a rare case of RPLS in a patient with UC.

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“…Reviewing previous reports on RPLS in patients with SLE, there are two types of RPLS-SLE: ''hypertensive RPLS,'' being reversible with conventional antihypertensive and anticonvulsive treatments concomitant with inactive SLE, and ''immunological RPLS,'' which requires immunosuppressive therapy and is considered a neurological manifestation of active SLE. Table 1 summarizes RPLS-SLE cases from the literature review [4,5,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Among these reports, there were 28 patients with SLE for whom adequate clinical information was provided for meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of reversible posterior leukoencephalopathy syndrome in patients with systemic lupus erythematosus

et al. 2011

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To characterize reversible posterior leukoencephalopathy syndrome (RPLS) in systemic lupus erythematosus (SLE) in terms of treatments for resolution and its clinical course, we reviewed 28 cases of RPLS in SLE including our cases in view of the treatment. Of these, 15 cases improved with blood pressure control and 13 required immunosuppressive therapy for activity of SLE presenting neurological manifestations. Patients without immunosuppressants at onset of RPLS more frequently required immunosuppressive therapy to recover it than those precedingly using these agents [31% (4/13) versus 87% (13/15), p = 0.008, chi-square test]. Brain magnetic resonance imaging (MRI) is important for diagnosis of RPLS-SLE in the patient with SLE who develops neurological disturbance and rapidly increasing blood pressure. When 7-day therapy for hypertension and convulsion does not reverse the manifestations, immunosuppressive treatments would be recommended to reverse RPLS.

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Reversible posterior leukoencephalopathy syndrome (RPLS) in a patient with systemic lupus erythematosus (SLE) and lupus nephritis

Cited by 8 publications

References 3 publications

Posterior Reversible Encephalopathy Syndrome: Clinicoradiological Spectrum and Therapeutic Strategies

Posterior Reversible Encephalopathy Syndrome: Clinicoradiological Spectrum and Therapeutic Strategies

Reversible Posterior Leukoencephalopathy Syndrome Associated with Treatment for Acute Exacerbation of Ulcerative Colitis

Clinical features of reversible posterior leukoencephalopathy syndrome in patients with systemic lupus erythematosus

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