Central-Variant Posterior Reversible Encephalopathy due to Sulfasalazine: A Case Report

Med Princ Pract. 2015;24(6):578-80. doi: 10.1159/000437386. Epub 2015 Aug 21.

Abstract

Objective: To report a rare case with central-variant posterior reversible encephalopathy syndrome due to sulfasalazine.

Clinical presentation and intervention: A 55-year-old female patient presented with seizure and acute-onset hemiparesia. Thirty days earlier, treatment with sulfasalazine was commenced in response to a diagnosis of psoriatic arthritis. Laboratory examinations were normal. Brain magnetic resonance imaging showed symmetric edema within basal ganglia and thalami with sparing of the cerebral cortices. After stopping the treatment of sulfasalazine, clinical and radiological findings regressed dramatically.

Conclusion: This was a case of central-variant posterior reversible encephalopathy syndrome due to sulfasalazine, and atypical imaging findings should be kept in mind for early diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Antirheumatic Agents / adverse effects*
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Psoriatic / drug therapy
  • Brain / pathology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Posterior Leukoencephalopathy Syndrome / chemically induced*
  • Seizures / chemically induced
  • Sulfasalazine / adverse effects*
  • Sulfasalazine / therapeutic use

Substances

  • Antirheumatic Agents
  • Sulfasalazine