Complete recovery of chronic Osmotic Demyelination Syndrome with plasma exchange

Main Article Content

Sumbal Nasir Mahmood*
Kunwer Naveed Mukhtar
Osama Kunwer Naveed
Ahmed Kunwer Naveed

Abstract

A 50-years old female presented with dysarthria, inability to swallow and quadriparesis for three weeks. She had rapid correction of her serum sodium (Na) from 99meq/l to 138meq/l within 24 hours 1 week prior to development of these symptoms. She was diagnosed as a case of Osmotic demyelination syndrome (ODS) formerly known as central pontine myelinolysis (CPM) which was confirmed by MRI. She underwent Plasma Exchange (PE) on the 20th day since her symptoms started and underwent 7 cycles of PE with complete neurological recovery. Pt was discharged with ability to ambulate independently and complete recovery of speech and swallowing. Hence, we report that PE is beneficial in chronic ODS.

Article Details

Mahmood, S. N., Mukhtar, K. N., Naveed, O. K., & Naveed, A. K. (2018). Complete recovery of chronic Osmotic Demyelination Syndrome with plasma exchange. Journal of Clinical Nephrology, 2(1), 005–007. https://doi.org/10.29328/journal.jcn.1001011
Case Reports

Copyright (c) 2018 Mahmood SN, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Gankam Kengne F, Soupart A, Pochet R, Brion JP, Decaux G. Reinduction of hyponatremia after rapid overcorrection of hyponatremia reduces mortality in rats. Kidney Int. 2009; 76: 614-621. Ref.: https://goo.gl/PKiHd9

Yamada H, Takano K, Ayuzawa N, Seki G, Fujita T. Relowering of serum Na for osmotic demyelinating syndrome. Case Rep Neurol Med. 2012. Ref.: https://goo.gl/z8LR7n

Chang KY, Lee IH, Kim GJ, Cho K, Park HS, et al. Plasma exchange successfully treats central pontine myelinolysis after acute hypernatremia from intravenous sodium bicarbonate therapy. BMC Nephrol. 2014; 15: 56. Ref.: https://goo.gl/ukH27g

King JD, Rosner MH. Osmotic Demyelination syndrome. Am J Med Sci. 2010; 339: 561-567. Ref.: https://goo.gl/aqpUEZ

Murthy SB, Izadyar S, Dhamne M, Kass JS, Goldsmith CE. Osmotic demyelination syndrome: variable clinical and radiologic response to intravenous immunoglobulin therapy. Neurol Sci. 2013; 4: 581-584. Ref.: https://goo.gl/TepmcX

Sardar GK, Eilbert WP. Severe hyponatremia associated with thiazide diuretic use. J Emerg Med. 2015; 48: 305-309. Ref.: https://goo.gl/ZLLjTA

Koller H, Kieseier BC, Jander S, Hartung HP. Chronic inflammatory demyelinating neuropathy. N Engl J Med. 2005; 352: 1343-1356. Ref.: https://goo.gl/MN8xN8

Louis G, Megarbane B, Lavoue S, Lassalle V, Argaud L, et al. Long term outcome of patients hospitalized in intensive care units with central or extrapontine myelinolysis. Crit Care Med. 2012; 40: 970-972. Ref.: https://goo.gl/5JRo4Z

Kumon S, Usui R, Kuzuhara S, Nitta K, Koike M. The improvement of the outcome of osmotic demyelination syndrome by Plasma exchange. Intern Med. 2017; 56: 733-736. Ref.: https://goo.gl/1zgNYY