A case of systemic sclerosis complicated reversible posterior leukoencephalopathy syndrome (RPLS)

Abstract

    A 33-year-old woman with systemic sclerosis was admitted to our hospital because of fever, headache and confusion. Although aseptic meningitis was diagnosed and her symptoms were improved by administration of antivirals and antibiotics, fever and elevated serum creatine kinase levels associated with scleroderma persisted. After she received high-dose glucocorticoid therapy, headache and confusion also relapsed. Brain magnetic resonance imaging showed hyperintense lesions in the posterior lobes on T₂-weighted and fluid-attenuated inversion recovery images. She was diagnosed with reversible posterior leukoencephalopathy syndrome and provided with control of blood and brain pressures. Her symptoms and imaging findings resolved immediately.