Abstract Details

Title Autoimmune Vs. Non-Autoimmune Pres: A Decade-Long Cohort Study On Differences In Clinical, Imaging, And Prognostic Features

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (5:00 PM-6:00 PM)

Poster/Presentation
Number 13-003

Objective To comprehensively characterize the distinct clinical, radiological profiles and outcomes of autoimmune and non-autoimmune PRES.

Background Posterior reversible encephalopathy syndrome (PRES) is an acute neurological disorder that is often reversible and can extend beyond the posterior regions of the brain. This study compares the clinical, radiological, and prognostic differences between autoimmune and non-autoimmune PRES using, given that the differences are not clear.

Design/Methods We conducted a 13-year retrospective review (2011–2024) of PRES patients, identified through ICD-10-CM codes. A panel of neuroradiologists, rheumatologists, and neurologists analyzed and classified the cases. Sociodemographic, clinical, imaging, and outcome data were collected. Fisher's exact test and the Chi-square test were used to detect significant differences (p < 0.05) between the groups.

Results Among the 146 patients with PRES, 86% were female. Autoimmune disorders (AD) were present in 32.8% of cases. Acute renal failure was associated with PRES in 71% of patients with AD (vs. 41% in the non-autoimmune group [NA]; p < 0.001). Diagnostic brain MRI showed vasogenic edema localized in the cerebellum in 38% of patients with AD PRES (vs. 15% in NA; p < 0.003). Status epilepticus occurred as a complication in 15% of patients with autoimmune PRES (vs. 4% in NA; p < 0.041). Long-term neurological sequelae were observed in 31% of patients with AD (vs. 52% in NA; p < 0.018). Conversely, motor manifestations were more frequent in the non-autoimmune group (14% vs. 2.1% in AD; p = 0.022).

Conclusions Our study found that autoimmune PRES is associated with higher rates of acute renal failure, cerebellar involvement, and status epilepticus, yet results in fewer long-term neurological sequelae. In contrast, non-autoimmune PRES exhibited more motor symptoms. These distinctions suggest the need for tailored diagnostic and treatment approaches based on etiology. Prospective studies are needed to confirm and understand these findings.

Authors/Disclosures
Laura J. Ballen, MD (Fundación Valle del Lili) PRESENTER	Dr. Ballen has nothing to disclose.
andres a. Hormaza jaramillo, MD	Dr. Hormaza jaramillo has nothing to disclose.
Ana M. Granados, MD	Dr. Granados has nothing to disclose.
Andres H. Tascon Barona	Dr. Tascon Barona has nothing to disclose.
Valentina Mejía-Quiñones, MD	Miss Mejía-Quiñones has nothing to disclose.
Daniela Peñaloza Gonzalez, Jr., MD	Miss Peñaloza Gonzalez has nothing to disclose.
Nathalia S. Coral, Sr., MD	Miss Coral has nothing to disclose.
Carlos A. Guzman Serrano, MD	Dr. Guzman Serrano has nothing to disclose.
Julian A. Rivillas, MD	Dr. Rivillas has nothing to disclose.

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