We describe a 37-yr-old man
who developed
central pontine myelinolysis (CPM) after allogeneic
hematopoietic stem cell transplantation (HSCT) for
acute lymphoblastic leukemia. After HSCT, desquamation developed on the whole body accompanied by
hyperbilirubinemia. The
liver biopsy of the
patient indicated
graft-versus-host disease- related
liver disease, and the
dose of
methylprednisolone was increased. Then, the
patient developed altered mentality with
eye ball deviation to the left, for which
electroencephalogram and
magnetic resonance imaging (MRI) scans were done.
Brain MRI scan demonstrated the imaging findings consistent with
central pontine myelinolysis and
extrapontine myelinolysis. He did not have any
hyponatremia episode during
hospitalization prior to the
MRI scan. To the best of our
knowledge, presentation of CPM after allogeneic HSCT is extremely rare in cases where
patients have not exhibited any episodes of significant
hyponatremia. We
report a rare case in which hepatic dysfunction due to
graft-versus-host disease has a strong
association with CPM after HSCT.