Autopsy report on central pontine myelinolysis triggered by vomiting associated with digoxin intoxication.
An 87-year-old male, prescribed digoxin and furosemide for congestive heart failure and Alzheimer disease, had dehydration and anemia due to poor food intake and hemorrhagic cystitis. Repeated vomiting due to an upper respiratory infection caused disturbance of consciousness and hypotension. The patient was admitted to hospital and diagnosed with digoxin intoxication and hypernatremia. The serum sodium (Na(+)) level was corrected, but the patient died 4 days after admission following uncontrollable seizure. A histologic examination after an autopsy revealed characteristic findings of central pontine myelinolysis (CPM). This is the first autopsy report on CPM triggered by vomiting in association with digoxin administration.
Department of Forensic Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Kana
K
Unuma
Kazuki
K
Harada
Makoto
M
Nakajima
Hiromi
H
Eguchi
Kensuke
K
Tsushima
Takako
T
Ito
Kaori
K
Shintani-Ishida
Hideaki
H
Kojima
Ken-ichi
K
Yoshida
D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002316:Cardiotonic Agents / Q000009:adverse effects* / Q000097:blood; D004077:Digoxin / Q000009:adverse effects* / Q000097:blood; D017809:Fatal Outcome; D049429:Forensic Pathology; D006801:Humans; D006955:Hypernatremia / Q000150:complications; D007008:Hypokalemia / Q000150:complications; D008297:Male; D017590:Myelinolysis, Central Pontine / Q000209:etiology* / Q000473:pathology*; D012141:Respiratory Tract Infections / Q000150:complications; D012640:Seizures / Q000209:etiology; D013194:Staining and Labeling; D014839:Vomiting / Q000150:complications* / Q000209:etiology
D002316:Cardiotonic Agents; D004077:Digoxin