Posterior Reversible Encephalopathy Syndrome in adult sickle-cell patients: Case series and literature review.

Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by headache, seizures, confusion, and visual disturbance. Usual culprits include hypertension, eclampsia, renal failure, or immunosuppressants. PRES has been described in sickle cell patients on a case report basis. More often than not, the patients are children or a recent blood transfusion was culprit. Few case reports describe adults with PRES. We present a series of four adult sickle-cell patients who developed PRES. The association of hypertension, renal failure, and immunosuppressants in sickle cell patients may play a role in the development of PRES in this patient population. It is unclear if SC patients have a higher frequency of PRES predisposing factors than the general population or if SC is an independent risk factor for PRES. Despite this limitation, the presence of acute neurological status changes in adult SC patients should trigger suspicion for PRES as management and outcome may be altered.