A CASE OF MONOCLONAL ANTIBODY (RITUXIMAB) INDUCED POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES) IN A PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

Background: This case report aims to present a rare occurrence of systemic lupus erythematosus (SLE) with posterior reversible encephalopathy syndrome (PRES) following rituximab therapy. We describe the clinical features, diagnostic evaluation, treatment, and outcomes of a patient diagnosed with SLE who developed PRES after receiving rituximab.

Case - The patient, a 23-year-old female known case of SLE, presented with sudden-onset neurological symptoms, including seizures and altered mental status, after receiving rituximab for management of lupus nephritis class IV not responding to mycophenolate mofetil. Brain imaging revealed characteristic findings consistent with PRES. Prompt intervention and discontinuation of rituximab were initiated, along with the administration of appropriate supportive care and immunosuppressive therapy. The patient demonstrated gradual improvement of neurological symptoms.

Conclusion: This case highlights the importance of recognizing the potential neurological complications, such as PRES, associated with rituximab therapy in patients with SLE. Early diagnosis and prompt management are crucial for achieving favorable outcomes.

Keywords: systemic lupus erythematosus, posterior reversible encephalopathy syndrome, PRES, rituximab, MRI