Vol.21 No.3

Original Article

Clinical features of reversible posterior leukoencephalopathy syndrome in patients with systemic lupus erythematosus

Authors

Yuichiro Fujieda¹ , Hiroshi Kataoka¹ , Toshio Odani¹ , Kotaro Otomo¹ , Masaru Kato¹ , Shinji Fukaya¹ , Kenji Oku¹ , Tetsuya Horita¹ , Shinsuke Yasuda¹ , Tatsuya Atsumi¹ , Takao Koike¹

Received:

12 August 2010

Accepted:

4 November 2010

Published online:

12 January 2011

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Abstract

To characterize reversible posterior leukoencephalopathy syndrome (RPLS) in systemic lupus erythematosus (SLE) in terms of treatments for resolution and its clinical course, we reviewed 28 cases of RPLS in SLE including our cases in view of the treatment. Of these, 15 cases improved with blood pressure control and 13 required immunosuppressive therapy for activity of SLE presenting neurological manifestations. Patients without immunosuppressants at onset of RPLS more frequently required immunosuppressive therapy to recover it than those precedingly using these agents [31% (4/13) versus 87% (13/15), p = 0.008, chi-square test]. Brain magnetic resonance imaging (MRI) is important for diagnosis of RPLS-SLE in the patient with SLE who develops neurological disturbance and rapidly increasing blood pressure. When 7-day therapy for hypertension and convulsion does not reverse the manifestations, immunosuppressive treatments would be recommended to reverse RPLS.

Key words

Reversible posterior leukoencephalopathy syndrome (RPLS) - Systemic lupus erythematosus (SLE) - Neuropsychiatric systemic lupus erythematosus (NPSLE) - Magnetic resonance imaging (MRI)