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Osmotic demyelination syndrome is usually associated with hyponatremia or rapid correction of this condition. The prognosis is usually fatal. We treated a 34-year-old chronic renal failure patient who did not have hyponatremia but developed severe pontine myelinolysis demonstrated with MRI. Serial MRI revealed gradual reduction of the lesions over 2 months. This case demonstrates that osmotic demyelination syndrome is not always associated with hyponatremia, and that, although the prognosis is usually poor, some patients recover.
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Ultrastruct Pathol
March 2025
Department of Medicine, Laboratory of Neurodegeneration and Regeneration URPHyM, NARILIS, University of Namur, Namur, Belgium.
Introduction: A murine model mimicking the human osmotic demyelination syndrome (ODS) revealed with histology demyelinated alterations in the relay posterolateral (VPL) and ventral posteromedial (VPM) thalamic nuclei 12 h and 48 h after chronic hyponatremia due to a fast reinstatement of osmolality. Abnormal expression astrocyte markers ALDHL1 and GFAP with immunohistochemistry in these ODS altered zones, prompted aims to verify in both protoplasmic and fibrillar astrocytes with ultrastructure those changes and other associated subcellular modifications.
Method: This ODS investigation included four groups of mice: Sham (NN; = 13), hyponatremic (HN; = 11), those sacrificed 12 h after a fast restoration of normal natremia (ODS12h; = 6), and mice sacrificed 48 h afterward, or ODS48 h ( = 9).
Ann Afr Med
March 2025
Department of Rheumatology, Center for Endocrinology, Diabetes, Arthritis and Rheumatism Superspeciality Healthcare, New Delhi, India.
Aims: Three percent hypertonic saline (3NS) is an established treatment for severe hyponatremia. The optimal regimen for administering 3NS for severe hyponatremia, with the aim to minimize side effects is not known. This systematic review and meta-analysis aimed to evaluate the safety profile of rapid intermittent bolus (RIB) versus slow continuous infusion (SCI) of 3NS for managing symptomatic severe hyponatremia.
View Article and Find Full Text PDFRev Invest Clin
March 2025
Departments of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Background: Osmotic demyelination syndrome is a rare neurological disorder caused by damage to the myelin sheath of oligodendrocytes, typically due to a rapid increase in serum osmolarity. Objective: The objective of the study was to investigate the factors associated with the development of pontine or extrapontine myelinolysis. Methods: A retrospective, observational study which included patients with magnetic resonance imaging-confirmed diagnosis of pontine and extrapontine myelinolysis from 1990 to 2024 at a referral hospital in Mexico City.
View Article and Find Full Text PDFClin Toxicol (Phila)
February 2025
Emergency Department, OLVG, Amsterdam, the Netherlands.
Introduction: The persistent increase in the use of 3,4-methylenedioxymetamfetamine has led to an increase in emergency department presentations. Our aim was to study the most frequent reasons for admission to the intensive care unit of critically ill patients with 3,4-methylenedioxymetamfetamine intoxication and to describe their complications, management and outcome.
Methods: This retrospective cohort study included all patients with confirmed or self-reported 3,4-methylenedioxymetamfetamine intoxication admitted to the intensive care of a tertiary care hospital in Amsterdam between 2010 and 2020.
BMC Nephrol
February 2025
Department of Medicine, Division of Nephrology, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267, US.
Background: Therapeutic Plasma Exchange (TPE) is an extracorporeal treatment modality used to manage certain conditions caused by plasma deficiencies, autoantibodies, alloantibodies, toxins, and immune complexes. We describe our experience of using TPE for various disease indications and associated complications.
Methods: This is a retrospective, single-center review of centrifuge-based TPE performed by the division of nephrology at a tertiary care academic center between July 2018 to June 2022.
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