AI Article Synopsis
- Rapid overcorrection of chronic hyponatremia can cause osmotic demyelination syndrome (CPM), often leading to neurological issues.
- A case study highlights an adult who developed post-operative delirium and was later found to have CPM through MRI after a liver transplant, despite initially having no typical symptoms.
- The findings suggest that CPM may be more prevalent in patients with cirrhosis due to chronic hyponatremia and rapid sodium correction, stressing the need for careful management of hyponatremia to avoid serious complications.
Article Abstract
Rapid overcorrection of chronic hyponatremia can lead to osmotic demyelination syndrome or central pontine myelinolysis (CPM), a diagnosis often triggered by observing the characteristics of neurological abnormalities developed as a result of CPM. However, anyone with chronic hyponatremia and overcorrection of serum sodium is at risk of physiological CPM despite the lack of clinical symptoms. We report an adult patient who presented as post-op delirium, had incidental finding of CPM by magnetic resonance imaging (MRI) of the head after a liver transplant. Despite his non-typical presentation, the patient had the typical risk factors of CPM such as chronic hyponatremia, rapid overcorrection of serum sodium and cirrhosis undergoing a transplant. As hyponatremia and neurological disorder such encephalopathy simultaneously affect patients with cirrhosis, CPM may be more common than once thought in the chronic liver disease population and inappropriate hyponatremia management has important medical consequences that can go unnoticed.
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| http://dx.doi.org/10.1016/j.aohep.2019.01.004 | DOI Listing |
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