AB1095 POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME IN A PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS AFTER COVID-19 VACCINATION: A CASE REPORT

Background The COVID-19 pandemic has infected millions of people around the world and there been a new surge virulent strains in many parts world[2]. Patients with Systemic Lupus Erythematosus (SLE) were reported to be at higher risk SARS-CoV-2 infection worse outcomes from COVID-19, possibly due their intrinsic immune dysfunction, demographics, disease activity, medications, associated organ damage, comorbidities as such, have among first receive vaccines [3]. most common reason for vaccine refusal patients SLE is fear flare. Additionally, mRNA could potentially induce interferon production, increased activity[1]. Objectives we report case presented lupus flare after receiving 1st dose phizer vaccine. Methods A 30-year-old female patient, kown since 2011 well controlled on low steroids, hydroxychloroquine azathioprine. Upon her shot Pfizer-BioNTech Vaccine, she developed high grade fever generalized tender papulovesicular skin eruption mainly back trunk outer surface both thighs, then tonic-clonic convulsions transferred Intensive Care Unit (ICU), intubated, mechanically ventilated received intravenous anti-epileptic medications. During admission, Cerebrospinal fluid (CSF) examination Magnetic Resonance Imaging (MRI) brain done.she regained consciousness, extubated 48 hours. Results initial laboratory invwstigations revealed COVID19-PCR: negative,ESR: 35 mm/hr,CRP: 78,C3: 70 mg/dL (90 – 180) C4: 8 (10 40).CSF proteins: 116.9 (15 45),glucose: 46.3 (50-60% serum),LDH: 49.1 U/L (10% serum) no cells.Emergency MRI was performed multiple bilateral symmetrical cortical subcortical abnormal signal swelling are seen involving occipito-temporo-parietal lobes patchy enhancement left cerebellar hemisphere, vermis, thalami, medulla pons,Picture suggestive Posterior Reversible Encephalopathy Syndrome (PRES).Accordingly patient pulse steroid therapy 3 days under cover oral acyclovir.She also levetiracetam Oxcarbazepine.the condition markedly improved discharged hospital follow up one month. Conclusion 1)The COVID Vaccine may rarely cause CNS affection, or even so, must before giving Vaccine. 2) monitored closely by clinical investigations taking References [1]Barbhaiya M, Levine JM,Siege C,Bykerk VP,Jannat-Khah D Mandl LA.1201 Flares SARS-Cov-2 vaccination systemic erythematosus. Science & Medicine 2021;8 [2]Fernandez-Ruiz R,Paredes JL Niewold TB. erythematosus: lessons learned infammatory disease.Transl Res.2021;232:13-36. [3]Tang W, Askanase AD, Khalili L, Merrill JT. SLE. Sci Med. 2021;8(1). Disclosure Interests None declared