Hypertensive encephalopathy is a recognised entity in patients with renal d
iseases and in patients on dialysis. Human recombinant erythropoietin is us
ed to treat anaemia in patients with end stage renal failure and it is know
n to cause hypertension in dialysis patients, even precipitating hypertensi
ve encephalopathy. Hinchey y cols. have described a new reversible posterio
r leukoencephalopathy syndrome, in which imaging abnormalities are seen in
the parieto-occipital regions of the brain in patient with hypertensive enc
ephalopathy or eclampsia, as well as in those receiving immunosuppresive tr
eatment. We describe a 47-year-old woman on hemodialysis, who, after starti
ng erythropoietin therapy, developed headache, blurred vision, and seizures
in the setting of a high blood pressure. Head CT revealed bilateral pariet
o-occipital hypodensity and T2-weighted MR showed high signal intensity in
the subcortical occipital white matter bilaterally. All symptoms and imagin
g abnormalities resolved following blood pressure control and stopping the
erythropoietin therapy.