Résumé
ABSTRACT Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological disorder that may include encephalopathy, seizures, headache, and visual disturbances. It is associated with conditions that induce endothelial damage, causing vasogenic cerebral edema that can be observed in magnetic resonance scans. It occurs in <1% of patients with systemic lupus erythematosus (SLE). It is usually resolved with timely treatment, but delays may lead to neurological sequelae or death. A case of PRES is presented in a patient with SLE with severe activity, a hypertensive emergency, and lupus glomerulonephritis debuting with epileptic status. The outcome was satisfactory with anticonvulsants, as well as treatment for her cerebral edema and hypertension, along with control of other causal factors.
RESUMEN El síndrome de encefalopatía posterior reversible (PRES) es un trastorno clínico-radiológico caracterizado por encefalopatía, convulsiones, cefalea y alteraciones visuales. Se asocia a entidades que ocasionan daño endotelial, causando edema cerebral vasogénico evidente en resonancia magnética. En pacientes con lupus eritematoso sistémico (LES) se presenta en < 1%. Con tratamiento oportuno usualmente resuelve; caso contrario puede producir secuelas neurológicas o muerte. Se reporta el caso de PRES en una paciente con LES con actividad severa, emergencia hipertensiva y glomerulonefritis lúpica que comienza con estatus epiléptico. Evolucionó satisfactoriamente con tratamiento anticonvulsivante, antiedema cerebral, antihipertensivo y control de los demás factores causales.