TNF and Hypertension: The other theory is a toxic effect, causing endothelial dysfunction and vasoconstriction that subsequently leads to edema.8 In such a way, infliximab, which binds to TNF-alpha, by antibody-dependent cellular toxicity or complement-dependent cytotoxicity, can lead to cell destruction and edema, which could be the mechanism behind PRES.9 In this case, hypertension was noted as the first manifestation, supporting the first theory.