An 81-year-old woman was hospitalized with progressive consciousness disturbance. Blood tests showed acidemia with severe renal dysfunction, and a cerebral spinal fluid (CSF) test showed pleocytosis with myelin basic protein (MBP) elevation. Brain magnetic resonance imaging showed unilaterally dominant subcortical white matter lesions with lentiform fork sign on T2-weighted imaging. After initiating hemodialysis, her consciousness disturbance and white matter lesions improved, suggesting uremic encephalopathy (UE). Unilaterally dominant leukoencephalopathy and high pleocytosis with MBP elevation in CSF are less common than previously identified characteristics of UE. When unilateral leukoencephalopathy occurs in patients with renal failure, UE should be considered.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208768 | PMC |
| http://dx.doi.org/10.2169/internalmedicine.9494-22 | DOI Listing |
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Article Synopsis
- In patients with chronic kidney disease undergoing dialysis, brain complications like Posterior Reversible Encephalopathy Syndrome and uremic encephalopathy can develop, with their potential reversibility depending on early detection and treatment.
- Neurological symptoms can range widely from mild consciousness disturbances to coma, and imaging plays a crucial role in diagnosing the specific underlying issues.
- Complications linked to dialysis include Dialysis Disequilibrium Syndrome and Osmotic Demyelination Syndrome, each showing unique imaging patterns, but accurate diagnosis often requires a detailed clinical history and lab results due to occasionally overlapping features.
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