title: Diffuse Leukoencephalopathy Associated with Dialysis Disequilibrium Syndrome.
abstract: A 52-year-old woman, previously treated for gastric cancer, began hemodialysis (HD) to treat the onset of severe acidemia. After her initial HD sessions, she suffered from a prolonged coma for approximately ten days. Magnetic resonance imaging revealed diffuse leukoencephalopathy, with increased apparent diffusion coefficient. Magnetic resonance spectroscopy showed a reduction of the N-acetylaspartate/creatine ratio. Her neuroimaging findings gradually resolved. Her transient cerebral white matter lesions were thought to be interstitial edema derived from dialysis disequilibrium syndrome (DDS), which might have been amplified by subclinical brain injury due to past chemotherapy. Her history of cancer chemotherapy may be a risk factor for an exacerbation of DDS.
authors.affiliation: Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan.
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Hayashi
authors.forename: Kozo
authors.initials: K
authors.lastname: Kitazawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sanada
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kato
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ohkoshi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Katsumata
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamaguchi
mesh_terms: D000138:Acidosis / Q000139:chemically induced / Q000628:therapy*; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D003128:Coma; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000209:etiology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D009325:Nausea / Q000209:etiology* / Q000628:therapy; D006435:Renal Dialysis / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology* / Q000628:therapy
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate