title: Treatable Leukoencephalopathy in a Patient with Hypophosphatemia.
abstract: We report the first patient with pathologically proven leukoencephalopathy associated with hypophosphatemia. A 61-year-old woman had repetitive episodes of decreased consciousness with pontine and pallidal lesions and extensive leukoencephalopathy on MRI, later found to be associated with hypophosphatemia. Although hypophosphatemia has been linked to central pontine and extrapontine myelinolysis (osmotic myelinolysis), lesions in the deep white matter have not been reported. Brain biopsy performed during the first diagnosis process revealed nonspecific demyelination with gliosis, a finding similar to that of chronic osmotic myelinolysis. After normalization of phosphate levels, her consciousness completely improved and MRI abnormalities partly resolved. We should consider that leukoencephalopathy can be associated with hypophosphatemia, which is often treatable.
authors.affiliation: Department of Neurology, Kindai University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okazaki
authors.affiliation: Department of Neurology, Kindai University Faculty of Medicine, Osakasayama, Japan; Department of Neurology, Sakai Hospital Kindai University Faculty of Medicine, Sakai, Japan.
authors.forename: Makito
authors.initials: M
authors.lastname: Hirano
authors.affiliation: Department of Neurology, Kindai University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Iwatsu
authors.affiliation: Department of Neurology, Kindai University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamana
authors.affiliation: Department of Neurology, Kindai University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Pathology, Kindai University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Satou
authors.affiliation: Department of Neurology, Kindai University Faculty of Medicine, Osakasayama, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kusunoki
keywords: Decreased phosphate level; Hypophosphatemia; Leukoencephalopathy; Osmotic myelinolysis; Phosphate binder