Posterior Reversible Encephalopathy Syndrome Triggered by Obinutuzumab in a Patient With Chronic Lymphocytic Leukemia

Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder that can affect all age groups. It appears to have higher incidence in the female population. Some common risk factors include hypertension, electrolyte abnormalities, sepsis, and chemotherapeutic medications such as Obinutuzumab. Our patient, who had chronic lymphocytic leukemia (CLL), presented with altered mental status. She was recently started on Obinutuzumab less than week before this presentation. MRI findings were consistent PRES, including diffuse vasogenic cerebral edema predominately throughout bilateral parietal occipital lobes associated some edematous extension into posterior part of frontal lobes. This case aims highlight importance early diagnosis by appropriately identifying features PRES improve patient quality life decrease morbidity mortality.