Posterior Reversible Encephalopathy Syndrome and Azathioprine

  • Sara Pinto Teixeira Vilas-Boas Serviço Medicina III, Hospital Prof. Doutor Fernando Fonseca, Lisbon, Portugal
  • Ana Corte-Real Serviço Medicina III, Hospital Prof. Doutor Fernando Fonseca, Lisbon, Portugal


seizures, azathioprine, Posterior reversible encephalopathy syndrome


Posterior reversible encephalopathy syndrome (PRES) is a rare syndrome that presents with neurological manifestations, often associated with arterial hypertension. Magnetic resonance imaging (MRI) shows bilateral white matter oedema in the posterior vascular territories. Immunosuppression, (pre) eclampsia and autoimmune diseases can be implicated. A 27-year-old woman, with mixed connective tissue disease under azathioprine, was admitted in the emergency room in status epilepticus and with severe hypertension. The MRI showed bilateral oedema in a pattern compatible with PRES. There was clinical improvement after azathioprine suspension. PRES is typically reversible with prompt recognition of the syndrome and its trigger. The association with azathioprine is rare.



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  • Published: 2019-01-25

    Issue: Vol 6 No 1 (view)

    Section: Articles

    How to cite:
    Vilas-Boas SPT, Corte-Real A. Posterior Reversible Encephalopathy Syndrome and Azathioprine. EJCRIM 2019;6 doi:10.12890/2019_001032.

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