Division of Rheumatology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Semin Arthritis Rheum. 2011 Dec;41(3):353-63. doi: 10.1016/j.semarthrit.2011.07.001. Epub 2011 Aug 24.
Posterior reversible encephalopathy syndrome (PRES) is a rare feature of systemic lupus erythematosus (SLE) that can present with seizures, visual disturbance, and/or hypertension. We describe 7 new cases of PRES in SLE patients that highlight some of the diagnostic and treatment dilemmas of this condition.
We obtained informed consent from patients for the review of their cases. A comprehensive literature search was done to find all published cases of PRES in SLE and these were compared with our cohort.
Including our series, there are 66 cases of PRES in SLE patients published in the English literature to date. Our series had 2 main distinguishing features when compared with the available literature: only 43% of our patients presented with seizures compared with 83 to 95% in the reported literature and over 50% of our cases of PRES occurred in newly diagnosed SLE.
PRES is a more frequent feature of SLE than previously thought and may be 1 of the presenting manifestations of SLE. Whether PRES is a manifestation of SLE disease activity and of its treatment or whether it represents a neuropsychiatric manifestation of SLE remain to be determined. Consequently there continues to be controversy as to whether immunosuppression should be used in addition to supportive measures in the treatment of PRES in SLE.
后部可逆性脑病综合征（PRES）是系统性红斑狼疮（SLE）的一种罕见特征，可表现为癫痫发作、视力障碍和/或高血压。我们描述了 7 例新的 SLE 患者 PRES 病例，突出了该病症的一些诊断和治疗难题。
我们获得了患者的知情同意，以回顾他们的病例。进行了全面的文献检索，以查找所有已发表的 SLE 患者 PRES 病例，并将其与我们的队列进行比较。
包括我们的系列在内，迄今为止，英文文献中已发表了 66 例 SLE 患者 PRES 病例。与现有文献相比，我们的系列有 2 个主要区别特征：与报道文献中 83%至 95%的患者出现癫痫发作相比，我们的患者中只有 43%出现癫痫发作，超过 50%的 PRES 病例发生在新诊断的 SLE 中。
PRES 是 SLE 比以前认为的更常见的特征，并且可能是 SLE 的表现之一。PRES 是 SLE 疾病活动和治疗的表现，还是 SLE 的神经精神表现，仍有待确定。因此，关于在 SLE 患者 PRES 的治疗中是否除支持措施外还应使用免疫抑制治疗，仍存在争议。
