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.