INTRODUCTION
Anti-glomerular basement membrane (anti-GBM) disease is a form of vasculitis where auto-antibodies attack antigens of the glomerular basement membrane leading to rapidly progressive glomerulonephritis.1 The complications surrounding this disease often circulate around renal and pulmonary pathologies. There is some mention of neurological complications associated with anti-GBM disease in literature, but the actual pathologies and mechanisms remain unclear. Some of the possible theories include cerebral vasculitis, metabolic encephalopathy, or posterior reversible encephalopathy syndrome (PRES).2 The pathogenesis of neurological symptoms in a patient with anti-GBM disease such as hypertensive emergency in the form of hypertensive encephalopathy, is clinically significant in patients with severe renal disease. Hypertensive encephalopathy is a diagnosis of exclusion thus involves extensive workup to rule out all other etiologies of neurologic dysfunction and BP dysregulation.3 Acute or chronic kidney disease, including anti-glomerular basement membrane disease (anti-GBM), are among well-known causes of hypertension and can lead to hypertensive emergencies.4,5 Here, we present a patient newly diagnosed with anti-GBM disease complicated by end-stage renal disease (ESRD) who had two hospital admissions for hypertensive emergency with seizures. Our work up, investigations, and treatment suggest hypertensive encephalopathy as the cause of seizures in our patient.