EJMCR |

Case Report

Volume: 9 | Issue: 6 | Published: Jul 25, 2025 | Pages: 130 - 134 | DOI: 10.24911/ejmcr.9-2073

Immunosuppressant therapyinduced posterior reversible encephalopathy syndrome: an emerging cause, a rare case report

Authors: Vinay Kumar Rastog , Paras Passi , Shashank Sadhwani , Prashant Surolia

Article Info

Authors

Vinay Kumar Rastog

Consultant, General Medicine, Jaipur Golden Hospital, Delhi, India

Paras Passi

Consultant, General Medicine, Jaipur Golden Hospital, Delhi, India

Shashank Sadhwani

DNB Family Medicine Trainee, Jaipur Golden Hospital, Delhi, India

ORCID

Prashant Surolia

General Medicine Trainee, Jaipur Golden Hospital, Delhi, India

Publication History

Received: April 10, 2025

Accepted: June 12, 2025

Published: July 25, 2025

Abstract

Background: Posterior reversible encephalopathy syndrome (PRES) is an acute or subacute cerebral syndrome, the main manifestations of which are headache, encephalopathy, seizures, or visual disturbances in various combinations; this case describes PRES related to drugs and toxic agents.

Case Presentation: We present a case of a 61-year-old female with a history of rheumatoid arthritis, hypothyroidism, dyslipidemia, and drug-induced neutropenia who developed PRES following the use of tab leflunomide. The patient presented with intense generalized itching, erythematous rash, and acute headache, progressing to confusion. Neuroimaging revealed leptomeningeal enhancement in the parieto-occipital regions, consistent with PRES. Prompt treatment with pulse steroid therapy, antihypertensive, and discontinuation of the tab leflunomide led to complete recovery.

Conclusion: This case highlights the importance of early recognition and management of triggering agent causing PRES in patients with autoimmune diseases on immunosuppressant therapy.

Keywords: Hypothyroidism, immunosuppressant therapy, posterior reversible encephalopathy syndrome (PRES), rheumatoid arthritis, case report.

Pubmed Style

Vinay Kumar Rastog, Paras Passi, Shashank Sadhwani, Prashant Surolia. Immunosuppressant therapyinduced posterior reversible encephalopathy syndrome: an emerging cause, a rare case report. EJMCR. 2025; 25 (July 2025): 130-134. doi:10.24911/ejmcr.9-2073

Web Style

Vinay Kumar Rastog, Paras Passi, Shashank Sadhwani, Prashant Surolia. Immunosuppressant therapyinduced posterior reversible encephalopathy syndrome: an emerging cause, a rare case report. https://www.ejmcr.com/articles/2073 [Access: August 14, 2025]. doi:10.24911/ejmcr.9-2073

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Vinay Kumar Rastog, Paras Passi, Shashank Sadhwani, Prashant Surolia. Immunosuppressant therapyinduced posterior reversible encephalopathy syndrome: an emerging cause, a rare case report. EJMCR. (2025), [cited August 14, 2025]; 25 (July 2025): 130-134. doi:10.24911/ejmcr.9-2073

Harvard Style

Vinay Kumar Rastog, Paras Passi, Shashank Sadhwani, Prashant Surolia (2025) Immunosuppressant therapyinduced posterior reversible encephalopathy syndrome: an emerging cause, a rare case report. EJMCR, 25 (July 2025): 130-134. doi:10.24911/ejmcr.9-2073

Chicago Style

Vinay Kumar Rastog, Paras Passi, Shashank Sadhwani, Prashant Surolia. "Immunosuppressant therapyinduced posterior reversible encephalopathy syndrome: an emerging cause, a rare case report." 25 (2025), 130-134. doi:10.24911/ejmcr.9-2073

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Vinay Kumar Rastog, Paras Passi, Shashank Sadhwani, Prashant Surolia (2025) Immunosuppressant therapyinduced posterior reversible encephalopathy syndrome: an emerging cause, a rare case report. , 25 (July 2025), 130-134. doi:10.24911/ejmcr.9-2073