{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T07:40:44Z","timestamp":1771918844217,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,8,10]],"date-time":"2019-08-10T00:00:00Z","timestamp":1565395200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 40-year-old Caucasian lady with focal crescentic glomerulonephritis (p-ANCA) demonstrated by kidney biopsy, was treated with intravenous pulse steroids followed by weekly outpatient rituximab infusions (375\u00a0mg\/m2). Five days after the fourth and final rituximab infusion, she developed headaches, altered mental status and seizures. Upon transfer to our facility, magnetic resonance imaging of the brain revealed cortical white matter changes suggestive of possible progressive multifocal leukoencephalopathy (PML) or posterior reversible encephalopathy syndrome (PRES). She was aggressively treated with antihypertensives, anti-seizure medications, intravenous steroids, plasmapheresis and ventilatory support while awaiting cerebrospinal fluid analysis and polymerase chain reaction on John Cunningham virus DNA. She had a complete recovery and, at 1 year follow up, was found to be doing well. Awareness of potential complications of rituximab therapy, such as PRES or PML is critical in providing appropriate treatment.<\/jats:p>","DOI":"10.1093\/omcr\/omz072","type":"journal-article","created":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T23:14:47Z","timestamp":1565392487000},"source":"Crossref","is-referenced-by-count":5,"title":["Rare but not beyond care: a young female with altered mental status and seizures"],"prefix":"10.1093","volume":"2019","author":[{"given":"Samata","family":"Pathireddy","sequence":"first","affiliation":[{"name":"Deaconess Health System, 600 Mary Street, Evansville, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subashish","family":"Bose","sequence":"additional","affiliation":[{"name":"Lynchburg Nephrology, 2091 Langhorne Road, Lynchburg, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishna","family":"Baradhi","sequence":"additional","affiliation":[{"name":"University of Oklahoma, 4444 E. 41st Street Tulsa, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8530-668X","authenticated-orcid":false,"given":"Narothama Reddy","family":"Aeddula","sequence":"additional","affiliation":[{"name":"Deaconess Health System, 600 Mary Street, Evansville, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,8,10]]},"reference":[{"key":"2019091012374372000_ref1","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.msard.2014.08.004","article-title":"Posterior reversible encephalopathy syndrome masquerading as progressive multifocal leukoencephalopathy in rituximab treated neuromyelitis optica","volume":"3","author":"Berger","year":"2014","journal-title":"Mult Scler Relat Disord"},{"key":"2019091012374372000_ref2","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJM199602223340803","article-title":"A reversible posterior leukoencephalopathy syndrome","volume":"334","author":"Hinchey","year":"1996","journal-title":"N Engl J Med"},{"key":"2019091012374372000_ref3","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1016\/B978-0-7020-4088-7.00109-7","article-title":"Posterior reversible encephalopathy syndrome","volume":"121","author":"Lamy","year":"2014","journal-title":"Handb Clin Neurol"},{"key":"2019091012374372000_ref4","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/j.1445-5994.2004.00750.x","article-title":"Reversible posterior leukoencephalopathy syndrome: a misnomer reviewed","volume":"35","author":"Stott","year":"2005","journal-title":"Intern Med J"},{"key":"2019091012374372000_ref5","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S1474-4422(10)70040-5","article-title":"Progressive multifocal leukoencephalopathy and other disorders caused by JC virus: clinical features and pathogenesis","volume":"9","author":"Tan","year":"2010","journal-title":"Lancet Neurol"},{"key":"2019091012374372000_ref6","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1007\/s13365-016-0459-y","article-title":"Progressive multifocal leukoencephalopathy in a patient without apparent immunosuppression","volume":"22","author":"Grewal","year":"2016","journal-title":"J Neurovirol"},{"key":"2019091012374372000_ref7","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1212\/WNL.0b013e3181f73600","article-title":"Incidence of progressive multifocal leukoencephalopathy in patients without HIV","volume":"75","author":"Amend","year":"2010","journal-title":"Neurology"},{"key":"2019091012374372000_ref8","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1111\/j.1468-1331.2011.03597.x","article-title":"Progressive multifocal leukoencephalopathy: a review of the neuroimaging features and differential diagnosis","volume":"19","author":"Sahraian","year":"2012","journal-title":"Eur J Neurol"},{"key":"2019091012374372000_ref9","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1212\/WNL.0b013e31828c2fa1","article-title":"PML diagnostic criteria: consensus statement from the AAN neuroinfectious disease section","volume":"80","author":"Berger","year":"2013","journal-title":"Neurology"},{"key":"2019091012374372000_ref10","article-title":"Posterior reversible leukoencephalopathy syndrome as a presenting manifestation of p-ANCA-associated vasculitis","author":"Patel","year":"2014","journal-title":"BMJ Case Rep"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/omcr\/article-pdf\/2019\/8\/omz072\/29549095\/omz072.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T17:57:44Z","timestamp":1568138264000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omz072\/5545640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,1]]},"references-count":10,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omz072","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,8]]},"published":{"date-parts":[[2019,8,1]]},"article-number":"omz072"}}