Kadikoy H et al. – The authors describe an unusual case of recurrent Posterior reversible encephalopathy syndrome (PRES) caused by uremia during a lupus flare in a patient with biopsy–proven Class IV Lupus Nephritis with vasculitis. PRES in systemic lupus erythematosis is a rare clinical phenomenon and, when reported, it is associated with hypertensive encephalopathy. The patient did not have hypertensive crisis, but had uremic encephalopathy. The patient's PRES–related symptoms resolved after initiation of hemodialysis.