Central pontine myelinolysis in the hyperosmolar hyperglycaemic state

To report a rare association of central pontine myelinolysis [CPM] with hyperosmolar hyperglycaemic state [HHS]. A diabetic female presented with HHS and prolonged severe hypernatraemia. The metabolic derangement was adequately treated with proper correction of both hyperglycaemia and hypernatraemia. Lack of improvement in the presenting confusional state and the development of a fresh neurological deterioration led to the suspicion of CPM that was confirmed with magnetic resonance imaging. She fully recovered after 4 weeks with no specific medical treatment. This case report showed that osmotic demyelination was linked to hypernatraemia and that CPM could result from severe hypernatraemia of HHS

Lymphocytic enterocolitis in Systemic Lupus Erythematosus

Microscopic colitis [MC] is a recognized cause of chronic watery diarrhea. It is characterized by subepithelial collagen deposition or intraepithelial lymphocytic infiltration of the colonic mucosa which, however, appears grossly normal on endoscopy. The term microscopic enterocolitis is applied when MC is associated with similar microscopic affection of the ileum and/or proximal small intestine. MC is reported to be associated with a variety of autoimmune conditions. Systemic lupus erythematosus [SLE] is rarely reported in association with MC. We report a female patient with microscopic enterocolitis as one of the presenting manifestations of SLE