Immunosuppressant therapy-induced Posterior Reversible Encephalopathy Syndrome- an emerging cause, a rare case report.

Posterior Reversible Encephalopathy Syndrome (PRES) is a rare neurological condition characterized by headache, loss of consciousness, seizures, and visual disturbances, often associated with labile hypertension. We present a case of a 61-year-old female with a history of rheumatoid arthritis, hypothyroidism, and dyslipidaemia, who developed PRES following the use of immunosuppressive medications. The patient presented with severe generalized itching, erythematous rash, and acute headache, progressing to confusion. Neuroimaging revealed leptomeningeal enhancement in the parieto-occipital regions, consistent with PRES. Prompt treatment with pulse steroid therapy, antihypertensives and discontinuation of immunosuppressive agent led to complete recovery. This case highlights the importance of early recognition and management of PRES in patients with autoimmune diseases on immunosuppressant therapy.