Osmotic demyelination syndrome after correction of severe hyponatremia associated with pituitrin.
Osmotic demyelination syndrome (ODS) may be precipitated by aggressive correction of a hypoosmolar state. We report the case of a 24-year-old woman who developed ODS during rapid correction of asymptomatic hyponatremia caused by pituitrin prescribed for hemoptysis. After hyponatremia correction by NaCl supplementation, the patient developed limb weakness, blurred vision, hand and perioral numbness, and lisp. Magnetic resonance imaging (MRI) revealed bilateral signal hyperintensity of the globus pallidus and caudate nucleus, compatible with extra-pontine ODS. These symptoms improved gradually with treatment, and brain MRI ~ 3 months later indicated substantial resolution of ODS. This case serves as a warning to physicians that hypoosmotic correction must be achieved at a controlled rate.
Dan Hua
DH
Xu
Min
M
Yuan
Jian Wen
JW
Wang
Yun Zhen
YZ
Hu
D003711:Demyelinating Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006469:Hemoptysis / Q000188:drug therapy*; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D009995:Osmosis; D026741:Physical Therapy Modalities; D010909:Pituitary Hormones, Posterior / Q000009:adverse effects*; D012720:Severity of Illness Index; D012965:Sodium Chloride / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D010909:Pituitary Hormones, Posterior; D012965:Sodium Chloride