TY - JOUR T1 - Atypical Posterior Reversible Encephalopathy Syndrome: A Flare of Systemic Lupus Erythematosus JF - The Journal of Rheumatology JO - J Rheumatol SP - 195 LP - 196 DO - 10.3899/jrheum.110838 VL - 39 IS - 1 AU - CECÍLIA MONTEIRO AU - ISABEL ALMEIDA AU - DANIEL DIAS AU - ERNESTINA SANTOS Y1 - 2012/01/01 UR - http://www.jrheum.org/content/39/1/195.abstract N2 - To the Editor:Posterior reversible encephalopathy syndrome (PRES) is typically characterized by headache, altered alertness and behavior, seizures, nausea, vomiting, and abnormalities of visual perception1. PRES has been described as an uncommon neurological manifestation in systemic lupus erythematosus (SLE), mainly associated with hypertension, renal insufficiency, and use of immunosuppressive drugs2. Cases without hypertension and/or renal dysfunction are very rare3,4. Endothelium dysfunction caused by systemic inflammation in SLE has been proposed as an alternative mechanism to the hypertension-induced cerebral autoregulatory dysfunction5. Use of hydroxy chloroquine (HCQ) therapy has recently been described as possibly associated with PRES4.A 45-year-old woman, a smoker who had had a diagnosis of cutaneous lupus for 2 years, was seen at our hospital for new-onset neurological symptoms. She had normal stature, no previous neurological symptoms such as migraine, and no family history of neurological disease. A diagnosis of lupus was based … Address correspondence to Dr. Monteiro; E-mail: cecilia.mmt{at}gmail.com ER -