Lupus & antiphospholipid syndrome
Risk factors and outcomes of posterior reversible encephalopathy syndrome in systemic lupus erythematosus: a retrospective-multicentre cohort study and systematic literature review
Authors' conclusion
In this cohort, most of the incident PRES episodes were preceded by hypertension and occurred in patients with LN. Although short-term and long-term prognoses are favourable, older patients more frequently experienced neurological sequelae.
Study context
- Population
- Patients with incident posterior reversible encephalopathy syndrome (PRES) and SLE (Mayo Clinic cohort and systematic literature review (SLR))53 from cohort study
- Participants
- 550 patients
- Outcome
- Clinical features, risk factors and outcomes of PRES in SLE
Methodological detailslogistic regression, Cox regression, Kaplan-Meier
- Logistic regression
- Cox regression
- Kaplan-Meier
Main finding
As reported in the abstract
- Female
- 92%
- Seizure (most common symptom)
- 80%
- PRES as first manifestation of SLE
- 13%
- Neurological sequelae with older age, adjusted OR per 10-year increase
- 1.63 (95% CI 1.12 to 2.39)
- Recurrent PRES after 5 years of follow-up
- 11.5% (95% CI 2.3 to 19.9%)
- 30-day survival
- 96.3% (95% CI 93.5 to 99.1%)
- 180-day survival
- 93.7% (95% CI 89.8 to 97.7%)
Observational data: associations, not effects.
Further findings
Mayo Clinic cohort: PRES attributed to hypertension with lupus nephritis (LN); ASM discontinuation · 5 years
- PRES attributed to hypertension in context of LN
- 81%
- Discontinued antiseizure medications (ASMs) by fifth year
- 78.1% (95% CI 58.7 to 88.4%)
Original publication
Risk factors and outcomes of posterior reversible encephalopathy syndrome in systemic lupus erythematosus: a retrospective-multicentre cohort study and systematic literature review. Lupus Sci Med. Published 11 December 2025. doi:10.
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