[Extrapontine myelinolysis of favorable outcome in a patient with autoimmune polyglandular syndrome].
BACKGROUND
Extrapontine myelinolysis is a well-known complication of hyponatremia and its treatment. It rarely occurs without central pontine myelinolysis, usually after overly rapid correction of hyponatremia. Its prognosis is considered poor.


METHODS
We report the case of a patient with autoimmune polyglandular syndrome with subacute adrenal failure responsible of severe hyponatremia. Despite a well-conducted treatment, the patient developed acute anxiety, catatonia, dysphagia and parkinsonism revealing extrapontine myelinolysis demonstrated on MRI. Outcome was favorable.


CONCLUSIONS
Extrapontine myelinolysis may occur in the absence of central pontine myelinolysis despite a treatment of hyponatremia conducted according to published guidelines. Treatment should be extremely cautious when hyponatremia has been lasting for more than 48 hours.
Koenig
M
M
Service de médecine interne, hôpital Nord, 42055 Saint-Etienne cedex 2, France.
Camdessanché
J P
JP
Duband
S
S
Charmion
S
S
Antoine
J C
JC
Cathébras
P
P
D000307:Adrenal Gland Diseases / Q000209:etiology; D000328:Adult; D001008:Anxiety Disorders / Q000209:etiology; D002389:Catatonia / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017590:Myelinolysis, Central Pontine / Q000209:etiology* / Q000473:pathology; D020734:Parkinsonian Disorders / Q000209:etiology; D016884:Polyendocrinopathies, Autoimmune / Q000150:complications*; D011379:Prognosis