A Case of Osmotic Demyelination Syndrome after Hemodialysis Treatment in a Uremic Patient with Severe Hyperosmolality / 대한신장학회잡지
Korean Journal of Nephrology
;
: 1035-1039, 2006.
Artigo
em Coreano
| WPRIM
| ID: wpr-226535
ABSTRACT
Osmotic demyelination syndrome (ODS) is a distinctive clinical syndrome with characteristic MR features in the central pons (central pontine myelinolysis) and in other brain locations (extrapontine myelinolysis). Rapid correction of hyponatremia is associated with ODS, but hyperosmolality rarely causes it. Here we report a case of ODS developed in a hemodialysis patient with severe uremia and concomitant hyperosmolality. A 67-year-old male was presented with general weakness and dyspnea. Laboratory findings showed severe uremia (blood urea nitrogen, 167 mg/dL; serum creatinine, 15 mg/dL), hyperosmolality (336 mOsm/kg H2O), and normal range of sodium (145 mEq/L). After the first hemodialysis treatment, his consciousness was changed to lethargic state. We initially suspected dialysis disequilibrium syndrome, but the symptoms were aggravated. MRI showed edema in central pons and symmetrical extrapotine lesions in the subcortical white matter, lateral thalamus, and posterior capsule, consistent with ODS. In spite of aggressive measures including continuous renal replacement therapy, he died of sepsis at the 26th hospital day.
Texto completo:
DisponíveL
Índice:
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Assunto principal:
Valores de Referência
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Sódio
/
Tálamo
/
Ureia
/
Uremia
/
Encéfalo
/
Ponte
/
Imageamento por Ressonância Magnética
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Diálise Renal
/
Doenças Desmielinizantes
Limite:
Idoso
/
Humanos
/
Masculino
Idioma:
Coreano
Revista:
Korean Journal of Nephrology
Ano de publicação:
2006
Tipo de documento:
Artigo
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