Clinical features and outcomes of posterior reversible encephalopathy syndrome in patients with systemic lupus erythematosus

Chien Chih Lai, Wei Sheng Chen, Yu Sheng Chang, Shu Hung Wang, Chun Jui Huang, Wan Yuo Guo, Wu Chang Yang, De Feng Huang

研究成果: 雜誌貢獻文章同行評審

43 引文 斯高帕斯(Scopus)


Objective To analyze the clinical features and outcomes of patients with posterior reversible encephalopathy syndrome (PRES), the risk factors of PRES-related intracranial hemorrhage (ICH), and all-cause mortality in patients with systemic lupus erythematosus (SLE). Methods Twenty-six episodes of PRES were identified in 23 SLE patients, using an electronic medical records database of 3,746 SLE patients. Results The prevalence of PRES was 0.69% among SLE patients. The scores of the SLE Disease Activity Index without neurologic descriptors (SLEDAI-N) were significantly elevated from baseline for a mean of 3.3 during PRES (P = 0.009). Rapidly deteriorating renal function, pulmonary hemorrhage, thrombotic microangiopathy, macrophage activation syndrome, or multiple organ dysfunction syndrome appeared during 65.4% of episodes. In 16 episodes, patients completely recovered from PRES-related symptoms within a median of 7 days. Visual impairment was reversed within 2 days in 8 of 15 patients, but impairment in other patients was protracted for up to 4 months, especially when ICH was present. Hypoalbuminemia (3; OR 21, 95% CI 1.27-346.93) were risk factors for PRES-related ICH. Patients with SLEDAI-N scores >18 during a PRES attack had significantly higher mortality rates than did patients with SLEDAI-N scores ≤18 (P = 0.009 by log rank test). Conclusion PRES frequently occurs during active SLE with multiple complications. Hypoalbuminemia and thrombocytopenia may contribute to PRES-related ICH. The extraneurologic disease activity of lupus during PRES may influence the mortality rate of SLE patients.
頁(從 - 到)1766-1774
期刊Arthritis Care and Research
出版狀態已發佈 - 11月 2013

ASJC Scopus subject areas

  • 風濕病


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