A case report of posterior reversible encephalopathy syndrome in a patient diagnosed with emphysematous necrotizing biliary pancreatitis

Abstract

Posterior reversible encephalopathy syndrome (PRES), a clinical radiological syndrome, is characterized by the abrupt development of neurological symptoms such as headaches, convulsions, altered sensorium, and visual problems. PRES has been linked to a number of risk factors or etiologies, including the use of immunosuppressants or cytotoxins, hypertensive encephalopathy, eclampsia, preeclampsia, and underlying autoimmune diseases. A 41-year-old female was admitted with acute necrotizing emphysematous pancreatitis complicated by posterior reversible encephalopathy syndrome. She remained normotensive on presentation and during the hospital stay. All her investigations were within normal except double-stranded DNA, which came positive. This could explain the immune-mediated mechanism leading to endothelial dysfunction. This case has been presented for its rarity. When acute neurological abnormalities occur in the context of systemic inflammatory conditions, such as acute pancreatitis, it is crucial to take PRES into account.