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Case Reports in Neurological Medicine
Volume 2013, Article ID 473618, 5 pages
http://dx.doi.org/10.1155/2013/473618
Case Report

Posterior Reversible Encephalopathy Syndrome in a Patient with Newly Diagnosed HIV Infection and End Stage Renal Disease

1Department of Neurology, Howard University Hospital, 2041 Georgia Avenue Northwest, Washington, DC 20001, USA
2Department of Internal Medicine, Howard University Howard, 2041 Georgia Avenue Northwest, Washington, DC 20001, USA

Received 8 March 2013; Accepted 8 April 2013

Academic Editors: J. E. Cohen and M. Moonis

Copyright © 2013 Mohankumar Kurukumbi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome in which patients present with an acute or subacute clinical presentation of seizures, visual disturbances, headache, and altered mental status. The pathophysiology of PRES may be explained by endothelial dysfunction that leads to transudation of fluids and protein, resulting in vasogenic cerebral edema. PRES is typically associated with many conditions such as hypertension, uremia, immunosuppressive drugs, and sepsis. This is a case report of a 39-year-old woman with untreated HIV infection and end-stage renal disease (ESRD) who developed PRES with a normal blood pressure and no other known causes of PRES. Untreated HIV is associated with known endothelial dysfunction and we believe that this, in combination with her untreated end-stage renal disease, contributed to her unique presentation of PRES. Although uncommon in HIV-infected patients and challenging to diagnose, prompt recognition of PRES is critical to provide appropriate care and ensure reversibility of the vasogenic edema seen in PRES.