Posterior Reversible Encephalopathy Syndrome and Systemic Lupus Erythematosus: An Underestimated Association Case report and Review of Pathophysiological Mechanisms

Posterior Reversible Encephalopathy Syndrome (PRES) is a rare clinico-radiological entity, and its global incidence remains unknown. It can be observed in various clinical circumstances, notably during Systemic Lupus Erythematosus (SLE). Its diagnosis is radiological, characterized by the appearance of vasogenic edema within the white matter, predominantly in the posterior parieto-occipital regions. The occurrence of PRES in the context of SLE is rare. Brain MRI with diffusion sequences is the examination of choice for diagnosis and follow-up. Controlling hypertension is the cornerstone of treatment and helps minimize sequelae. The objective of our study is to report a clinical case of a patient followed for lupus nephropathy who developed PRES and to describe pathophysiological mechanisms. We report a case of a 46-year-old female patient with a history of SLE, admitted with impaired consciousness, convulsive seizures, and a hypertensive peak of 170/110 mmHg. Brain imaging confirmed the diagnosis of PRES, reinforcing the clinical suspicion. Treatment mainly consisted of managing arterial hypertension and preventing recurrent seizures. The patient fully recovered without any persistent neurological deficits. PRES is a rare condition, and appropriate management of its clinical manifestations is crucial to prevent both clinical and radiological sequelae.