Rare but not beyond care: a young female with altered mental
Rituximab treatment is associated with rare but significant adverse events of posterior reversible encephalopathy syndrome (PRES) or progressive multifocal leukoencephalopathy (PML). This case highlights the need for clinical acumen, awareness, early recognition of neurological symptoms and diagnosis related to such rare complications.

A 40-year-old Caucasian lady with a prior medical history of chronic kidney disease stage 4 with a recently diagnosed biopsy-proven focal crescentic glomerulonephritis (p-ANCA), chronic obstructive pulmonary disease, obstructive sleep apnea (OSA), diabetes mellitus type 2, hypertension and morbid obesity was transferred from outside hospital (OSH) with altered mental status, headaches and generalized tonic-clonic seizures.

Given rapid clinical deterioration and progressive cognitive decline, she was transferred to this facility. Upon arrival, the patient’s Glasgow Coma Scale was 4, was hypoxic and required emergent endotracheal intubation.

Source: Oxford medical case reports

Read more: https://academic.oup.com/omcr/article/2019/8/omz072/5545640
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