دورية أكاديمية
أعرض في EDS

Refractory Hypernatremia and Osmotic Demyelination Syndrome After Liver Transplantation: A Case Report.

التفاصيل البيبلوغرافية
العنوان: Refractory Hypernatremia and Osmotic Demyelination Syndrome After Liver Transplantation: A Case Report.
المؤلفون: Ferreira GSA; Liver Transplant Division, Federal District Institute of Cardiology, Brasília, Brazil. Electronic address: gustferr@ufmg.br., Watanabe ALC; Liver Transplant Division, Federal District Institute of Cardiology, Brasília, Brazil., Trevizoli NC; Liver Transplant Division, Federal District Institute of Cardiology, Brasília, Brazil., Figueira AVF; Liver Transplant Division, Federal District Institute of Cardiology, Brasília, Brazil., Caja GON; Liver Transplant Division, Federal District Institute of Cardiology, Brasília, Brazil., Murta MCB; General Surgery Department, Doutor Celio de Castro Metropolitan Hospital, Brazil., Ferreira CA; General Surgery Department, Doutor Celio de Castro Metropolitan Hospital, Brazil., Moreira ML; General Surgery Department, Doutor Celio de Castro Metropolitan Hospital, Brazil., Couto CF; Liver Transplant Division, Federal District Institute of Cardiology, Brasília, Brazil.
المصدر: Transplantation proceedings [Transplant Proc] 2022 Jun; Vol. 54 (5), pp. 1376-1379. Date of Electronic Publication: 2022 Jun 25.
نوع المنشور: Case Reports; Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Science Inc Country of Publication: United States NLM ID: 0243532 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2623 (Electronic) Linking ISSN: 00411345 NLM ISO Abbreviation: Transplant Proc Subsets: MEDLINE
أسماء مطبوعة: Publication: New York, N.Y. : Elsevier Science Inc.
Original Publication: New York Stratton.
مواضيع طبية MeSH: Demyelinating Diseases*/diagnosis , Demyelinating Diseases*/etiology , Hypernatremia*/complications , Hypernatremia*/etiology , Hyponatremia*/diagnosis , Hyponatremia*/etiology , Liver Transplantation*/adverse effects, Adult ; Humans ; Liver Cirrhosis/complications ; Liver Cirrhosis/surgery ; Male ; Sodium ; Syndrome
مستخلص: Osmotic demyelination syndrome is an uncommon neurologic condition, characterized by noninflammatory demyelination involving the pons and other areas of the central nervous system. As chronic hyponatremia is frequently associated with cirrhosis, patients undergoing liver transplantation are at an increased risk for developing this condition. We report the case of a patient who developed refractory hypernatremia and osmotic demyelination syndrome after liver transplantation. The patient was a 40-year-old man, who underwent liver transplantation for the treatment of cryptogenic cirrhosis, and had a preoperative sodium level of 128 mmol/L. Although there were no intraoperative complications, the patient showed signs of mental confusion and drowsiness in the second postoperative day, and we noticed an increase to 136 mmol/L in his serum sodium. Treatment with 5% dextrose and desmopressin was initiated, but his serum sodium continued to increase steadily, while his neurologic condition gradually worsened. Serum sodium rose to 157 mmol/L, and a magnetic resonance imaging of the brain showed extensive lesions consistent with osmotic demyelination syndrome. The clinical condition of the patient continued to deteriorate until his death 17 days after the transplant. Although the occurrence of this syndrome after liver transplantation is well described, the steady increase in serum sodium despite early treatment, as described in this case, is highly unusual, and highlights the great attention that must be taken with monitoring and control of serum sodium in patients who undergo liver transplant in the context of chronic hyponatremia. This manuscript is compliant with the Helsinki Congress and the Istanbul Declaration.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
المشرفين على المادة: 9NEZ333N27 (Sodium)
تواريخ الأحداث: Date Created: 20220627 Date Completed: 20220823 Latest Revision: 20220823
رمز التحديث: 20221213
DOI: 10.1016/j.transproceed.2022.03.034
PMID: 35760624
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-2623
DOI:10.1016/j.transproceed.2022.03.034