Posterior reversible encephalopathy syndrome in the setting of COPD: Proposed pathogenesis

Posterior reversible encephalopathy syndrome (PRES) has been associated with many conditions – particularly inflammatory, neoplastic and following organ failure. We submit that Chronic Obstructive Pulmonary Disease (COPD) is a significant predisposing factor for a number of these cases. Increased levels of circulating TNF-alpha, IL-1 and endothelin-1 (ET-1) are herein proposed as key mediators of this association. This theory builds on the central role of endothelial dysfunction in the pathogenesis of PRES.