title: Extrapontine myelinolysis associated with pituitrin: case report and literature review.
abstract: BACKGROUND
  Hyponatremia is the most common electrolyte abnormality encountered in hospitalized patients, resulting from a varied spectrum of conditions. Both the primary disturbance and its correction can result in life-threatening neurological consequences. Extrapontine myelinolysis is one such complication that is associated with the rapid correction of hyponatremia. Here we describe a patient who developed extrapontine myelinolysis unexpectedly after the correction of hyponatremia, which involved the drug pituitrin.
  
  
  METHODS
  A 24-year-old Chinese woman was transferred to our neurology department with the symptoms of dysarthria and quadriparesis developing one day after the correction of hyponatremia (from 118 mmol/L to 140 mmol/L), which followed with a continuous intravenous drip of pituitrin used to control hemoptysis in the emergency room. During the course, she developed involuntary movement. Magnetic resonance imaging changes were consistent with extrapontine myelinolysis.
  
  
  CONCLUSIONS
  This present case describes the mechanism of profound hyponatremia involving pituitrin, and the subsequent development of extrapontine myelinolysis. Physicians may approach effective clinical management of patients through awareness of the adverse effect of pituitrin on serum sodium levels, and avoid rapid correction of hyponatremia in clinical practice.
authors.affiliation: Department of Neurology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China. zhuangliying43205409@126.com.|Department of Neurology, Zhejiang Hospital, Hangzhou, 310013, Zhejiang, China. zhuangliying43205409@126.com.
authors.forename: Liying
authors.initials: L
authors.lastname: Zhuang
authors.affiliation: Department of Neurology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China. ziqi2458@163.com.
authors.forename: Ziqi
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Neurology, Zhejiang Hospital, Hangzhou, 310013, Zhejiang, China. tjqlyg@163.com.
authors.forename: Yaguo
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neurology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China. luobenyan@zju.edu.cn.
authors.forename: Benyan
authors.initials: B
authors.lastname: Luo
mesh_terms: D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D017590:Myelinolysis, Central Pontine / Q000139:chemically induced*; D010909:Pituitary Hormones, Posterior / Q000008:administration & dosage / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D010909:Pituitary Hormones, Posterior