Pontine Myelinolysis Caused by Hypovolemic Hypernatremia

Introduction. Central pontine myelinolysis is characterized by the occurrence of acute demyelinating lesions of cells in the pons secondary to abrupt oscillations of serum osmolarity. Its exact incidence is not well defined, but studies show a prevalence of 0.25 to 0.5% in the general population, 2....

Full description

Saved in:
Bibliographic Details
Main Authors: D. O. Beraldo, S. B. C. P. Duarte, R. B. Santos, C. G. Mendes, M. P. Silveira, A. S. Neto, M. M. Silva, L. G. Oliveira, A. V. Bonfim, A. A. Teixeira, R. A. Teixeira
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Nephrology
Online Access:http://dx.doi.org/10.1155/2020/4079098
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849401247583436800
author D. O. Beraldo
S. B. C. P. Duarte
R. B. Santos
C. G. Mendes
M. P. Silveira
A. S. Neto
M. M. Silva
L. G. Oliveira
A. V. Bonfim
A. A. Teixeira
R. A. Teixeira
author_facet D. O. Beraldo
S. B. C. P. Duarte
R. B. Santos
C. G. Mendes
M. P. Silveira
A. S. Neto
M. M. Silva
L. G. Oliveira
A. V. Bonfim
A. A. Teixeira
R. A. Teixeira
author_sort D. O. Beraldo
collection DOAJ
description Introduction. Central pontine myelinolysis is characterized by the occurrence of acute demyelinating lesions of cells in the pons secondary to abrupt oscillations of serum osmolarity. Its exact incidence is not well defined, but studies show a prevalence of 0.25 to 0.5% in the general population, 2.5% in the intensive care unit, and up to 10% in patients with risk factors, such as chronic liver disease and hepatic transplantation, alcoholism, malnutrition, diuretic therapy, electrolyte imbalance, hypoglycemia, and hyperglycemia. Case Report. A 70-year-old white female with extranodal diffuse large B-cell non-Hodgkin’s lymphoma (extensive mass on the left anterior chest wall), stage IVA, developed pontine myelinolysis secondary to hypovolemic acute hypernatremia, which occurred due to diarrhea caused by chemotherapy (rituximab, cyclophosphamide, doxorubicin, and vincristine). Discussion. Pontine myelinolysis occurs most often due to the rapid correction of chronic hyponatremia. But here, we describe a case of the disease secondary to the occurrence of hypovolemic acute hypernatremia in a patient with a hematological malignancy under treatment, who was on chronic treatment with thiazide diuretics and who presented with other electrolyte disturbances as risk factors for the development of pontine myelinolysis.
format Article
id doaj-art-8a240c96408547ad9907acbcd2de0fc8
institution Kabale University
issn 2090-6641
2090-665X
language English
publishDate 2020-01-01
publisher Wiley
record_format Article
series Case Reports in Nephrology
spelling doaj-art-8a240c96408547ad9907acbcd2de0fc82025-08-20T03:37:49ZengWileyCase Reports in Nephrology2090-66412090-665X2020-01-01202010.1155/2020/40790984079098Pontine Myelinolysis Caused by Hypovolemic HypernatremiaD. O. Beraldo0S. B. C. P. Duarte1R. B. Santos2C. G. Mendes3M. P. Silveira4A. S. Neto5M. M. Silva6L. G. Oliveira7A. V. Bonfim8A. A. Teixeira9R. A. Teixeira10Hospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilHospital Renascentista, Pouso Alegre, MG, BrazilIntroduction. Central pontine myelinolysis is characterized by the occurrence of acute demyelinating lesions of cells in the pons secondary to abrupt oscillations of serum osmolarity. Its exact incidence is not well defined, but studies show a prevalence of 0.25 to 0.5% in the general population, 2.5% in the intensive care unit, and up to 10% in patients with risk factors, such as chronic liver disease and hepatic transplantation, alcoholism, malnutrition, diuretic therapy, electrolyte imbalance, hypoglycemia, and hyperglycemia. Case Report. A 70-year-old white female with extranodal diffuse large B-cell non-Hodgkin’s lymphoma (extensive mass on the left anterior chest wall), stage IVA, developed pontine myelinolysis secondary to hypovolemic acute hypernatremia, which occurred due to diarrhea caused by chemotherapy (rituximab, cyclophosphamide, doxorubicin, and vincristine). Discussion. Pontine myelinolysis occurs most often due to the rapid correction of chronic hyponatremia. But here, we describe a case of the disease secondary to the occurrence of hypovolemic acute hypernatremia in a patient with a hematological malignancy under treatment, who was on chronic treatment with thiazide diuretics and who presented with other electrolyte disturbances as risk factors for the development of pontine myelinolysis.http://dx.doi.org/10.1155/2020/4079098
spellingShingle D. O. Beraldo
S. B. C. P. Duarte
R. B. Santos
C. G. Mendes
M. P. Silveira
A. S. Neto
M. M. Silva
L. G. Oliveira
A. V. Bonfim
A. A. Teixeira
R. A. Teixeira
Pontine Myelinolysis Caused by Hypovolemic Hypernatremia
Case Reports in Nephrology
title Pontine Myelinolysis Caused by Hypovolemic Hypernatremia
title_full Pontine Myelinolysis Caused by Hypovolemic Hypernatremia
title_fullStr Pontine Myelinolysis Caused by Hypovolemic Hypernatremia
title_full_unstemmed Pontine Myelinolysis Caused by Hypovolemic Hypernatremia
title_short Pontine Myelinolysis Caused by Hypovolemic Hypernatremia
title_sort pontine myelinolysis caused by hypovolemic hypernatremia
url http://dx.doi.org/10.1155/2020/4079098
work_keys_str_mv AT doberaldo pontinemyelinolysiscausedbyhypovolemichypernatremia
AT sbcpduarte pontinemyelinolysiscausedbyhypovolemichypernatremia
AT rbsantos pontinemyelinolysiscausedbyhypovolemichypernatremia
AT cgmendes pontinemyelinolysiscausedbyhypovolemichypernatremia
AT mpsilveira pontinemyelinolysiscausedbyhypovolemichypernatremia
AT asneto pontinemyelinolysiscausedbyhypovolemichypernatremia
AT mmsilva pontinemyelinolysiscausedbyhypovolemichypernatremia
AT lgoliveira pontinemyelinolysiscausedbyhypovolemichypernatremia
AT avbonfim pontinemyelinolysiscausedbyhypovolemichypernatremia
AT aateixeira pontinemyelinolysiscausedbyhypovolemichypernatremia
AT rateixeira pontinemyelinolysiscausedbyhypovolemichypernatremia