PRES in Lupus Nephritis and Sickle Cell Trait: A Diagnostic and Therapeutic Challenge

Posterior reversible encephalopathy syndrome (PRES) is a rare, potentially reversible clinico-radiological condition affecting a small percentage of patients with systemic lupus erythematosus (SLE). This case report describes a 26- year-old female with SLE and type IV lupus nephritis who presented with seizures, altered sensorium, and hypertension. MRI revealed bilateral symmetrical T2/FLAIR hyperintensities in multiple brain regions, confirming PRES. Despite intensive management, including antihypertensive and anticonvulsant therapy and extraventricular drain placement for hydrocephalus, the patient developed multiorgan dysfunction and succumbed following cardiac arrest. This case underscores the importance of considering PRES in young females with SLE presenting with neurological symptoms and highlights the need for prompt radiological diagnosis and management to prevent irreversible damage or death.