Central Pontine and Extrapontine Myelinolysis: Experience from a Single Liver Transplantation Center
DOI:
https://doi.org/10.24950/rspmi.737Keywords:
Hyponatremia, Liver Transplantation, Central PontineAbstract
Introduction: Central pontine and extrapontine myelinolysis
(CPEPM) is a rare demyelinating syndrome. It has been observed
to be more prevalent in liver transplant recipients, with
worse prognosis. Rapid corrections of hyponatremia and immunosuppressive
agents, such as calcineurin inhibitors, have
been pointed as possible causes for the development of this
pathology.
Methods: The authors report a review of five patients that underwent
liver transplantation. Upon admission in the intensive
care unit, they developed neurological signs and symptoms
identified through brain magnetic resonance imaging, compatible
with CPEPM, illustrated in a simple chart.
Results: Heavy ethanol consumption, hepatic encephalopathy
syndrome and hyponatremia were the most common features
previous to the surgical procedure. Four of the five patients
presented intra-operative serum sodium variation above the
recommended values.
Conclusion: The authors reviewed the documented cases of
CPEPM in a liver transplantation reference centre, in order to
evaluate the prevalence, clinical presentation and outcomes
of this condition.
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