Curr Health Sci J, vol. 47, no. 2, 2021

Atypical Posterior Reversible Encephalopathy Syndrome (PRES) in a Patient with Polymyalgia Rheumatica and Giant Cell Arteritis

[Case Report]

Paolo Falsetti(1), Caterina Acciai(2), Edoardo Conticini(1), Luca Cantarini(1), Bruno Frediani(1)


(1)Rheumatology Unit, University of Siena, Santa Maria alle Scotte Hospital, Siena, Italy,
(2)Neurorehabilitation Unit, S. Donato Hospital, Arezzo, Italy


Abstract:

Posterior reversible encephalopathy syndrome (PRES) is a potentially life-threatening condition, composed of focal neurologic symptoms and peculiar magnetic resonance imaging (MRI) findings suggestive for cerebral vasogenic edema. PRES has been predominantly associated with severe hypertension, but a concomitant inflammatory state, common in vasculitis, can contribute to worsening cerebral vasogenic edema towards cytotoxic edema, and it should be promptly treated with glucocorticoids (GC). Atypical cases of PRES should be suspected in cases of focal neurologic symptoms, associated with severe hypertension, and systemic inflammation. We report the first description of a patient with polymyalgia rheumatica and giant cell arteritis who developed PRES after GC discontinuation for arthroscopic surgery.


Keywords:
PRES, Posterior reversible encephalopathy syndrome, Polymyalgia rheumatica, Giant cell arteritis



Corresponding:
Paolo Falsetti, Rheumatology Unit, University of Siena, Siena, Italy, Rheumatology Unit, University of Siena, Le Scotte Hospital, Viale Bracci 53100 Siena, Italy, e-mail: paolo.falsetti@virgilio.it


DOI 10.12865/CHSJ.47.02.23 - Download PDF