一名妊娠剧吐患者在纠正低钠血症后出现紧张性惊厥，其渗透性脱髓鞘综合征对浆血疗法的反应

Q3 Medicine

European journal of case reports in internal medicine Pub Date : 2024-03-11 DOI:10.12890/2024_004373

Vimonsri Rangsrisaeneepitak, Arnant Tekarnjnavanit, Pattarapol Kanjanapipatkul, Sukrisd Koowattanatianchai

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引用次数: 0

摘要

渗透性脱髓鞘综合征（ODS）是一种以桥脑和桥外区广泛发生脱髓鞘为特征的疾病。它被认为是快速纠正低钠血症引起的并发症。本研究提供了一例 20 岁的泰国女性患者的病例，她怀孕 10 周，最初表现为紧张性精神分裂症，这是 ODS 的一种不常见表现。患者在妊娠剧吐的情况下迅速纠正低钠血症后出现症状。脑部磁共振成像（MRI）显示，中央脑桥的T2加权和液体增强反转恢复（FLAIR）序列呈三叉戟或蝙蝠翼状。患者接受了五个周期的血浆置换术和康复治疗，临床症状有所改善。

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The response of osmotic demyelination syndrome to plasmapheresis in a patient presenting with catatonia after correction of hyponatraemia in hyperemesis gravidarum

Osmotic demyelination syndrome (ODS) is a disorder characterised by the widespread development of demyelination in both pontine and extrapontine regions. It has been recognised as a complication arising from the rapid correction of hyponatraemia. This study presents the case of a 20-year-old Thai female patient at 10 weeks gestation, exhibiting an initial presentation of catatonia – an uncommon manifestation of ODS. The patient developed symptoms following the rapid correction of hyponatraemia in the context of hyperemesis gravidarum. Magnetic resonance imaging (MRI) of the brain revealed a trident or bat-wing-shaped pattern in T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences at the central pons. The patient underwent five cycles of plasmapheresis and received rehabilitation, leading to clinical improvement.

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来源期刊

European journal of case reports in internal medicine

CiteScore

2.10

自引率

0.00%

发文量

166

审稿时长

8 weeks

期刊介绍： The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.