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Journal of Medical Case Reports

, 8:442

First Online: 18 December 2014Received: 11 September 2014Accepted: 10 November 2014DOI: 10.1186-1752-1947-8-442

Cite this article as: Jayaweera, J.L., Withana, M.R., Dalpatadu, C.K. et al. J Med Case Reports 2014 8: 442. doi:10.1186-1752-1947-8-442


IntroductionPosterior reversible encephalopathy syndrome is a clinicoradiologic entity characterized by headache, seizures, decreased vision, impaired consciousness and white matter oedema in bilateral occipitoparietal regions. Hypertensive encephalopathy, eclampsia, immunosuppressive-cytotoxic drugs, organ transplantation, renal disease, autoimmune diseases and vasculitides are reported risk factors of posterior reversible encephalopathy syndrome. Reports of cyclophosphamide-induced posterior reversible encephalopathy syndrome are rare and occurred in a background of renal failure, fluid overload or active connective tissue disease.

Case presentationWe report a case of posterior reversible encephalopathy syndrome developing as a direct consequence of intravenous cyclophosphamide therapy in a 33-year-old normotensive Sri Lankan woman with lupus nephritis but quiescent disease activity and normal renal function.

ConclusionsThis case report highlights the need for awareness and early recognition of this rare but serious adverse effect of cyclophosphamide that occurred in the absence of other known risk factors of posterior reversible encephalopathy syndrome and that early appropriate intervention leads to a good outcome.

KeywordsCyclophosphamide Posterior reversible encephalopathy syndrome PRES Systemic lupus erythematosus AbbreviationsGCSGlasgow Coma Scale

GTCSGeneralized tonic–clonic seizures

PRESPosterior reversible encephalopathy syndrome

RBCRed blood cells

SLESystemic lupus erythematosus.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-8-442 contains supplementary material, which is available to authorized users.

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