복막투석 환자에서 발생한 중심성 뇌교 수초용해증 1예
A case of central pontine myelinolysis in uremic patient with peritoneal dialysis
소속 상세정보
이승훈/Seung Hoon Lee
송호철/김형준/김현재/박선미/유원종/최의진/방병기/Ho Cheol Song/Hyung Jun Kim/Hyeon Jae Kim/Sun Mi Park/Won Jong Yu/Euy Jin Choi/Byung Ki Bang
KMID : 0882420010610060660
Abstract
중심성 뇌교 수초용해증 (CPM)은 알코올 중독, 영양실조, 간 질환, 화상, 암, Addison씨병 및 탈수증 등에서 전해질 불균형상태, 특히 저나트륨혈증을 급속히 교정한 후에 발생하는 것으로 알려져 있으며 뇌 CT나 MRI상 전형적으로 나타나는 병변을 특징으로 한다.
저자들은 복막투석 중인 환자에서 저나트륨혈증 없이 발생한 사지마지, 구음장애, 연하곤란 및 'Lock-in' 증후군을 나타내며 뇌 MRI상 확인된 CPM을 경험하였기에 보고하는 바이다.
Central pontine myelinolysis (CPM) is a rare syndrome, especially in uremic patients undergoing dialysis. CPM induced by diabetic coma in hemodialysis patients or associated with rapid correction of hyponatremia in peritoneal dialysis patients
have
been reported. However, its pathogenesis has been unclear. We report a case of CPM in a 67-year-old female uremic patient undergoing continuous ambulatory peritoneal dialysis, who was admitted to our hospital for drowsy mentality. Sodium was
normal
(140
mEq/L) initially and throughout the entire clinical course. The fasting blood sugar level was 110 ㎎
/dL, serum osmolality 312 mOsm/㎏H2O and osmolar gap 9.47. The axial T2-weighted brain MRI showed high signal intensity in the basal pons.
Myelinolysis; Central pontine; Sodium; Continuous ambulatory pertoneal dialysis; Magnetic resonance imaging;
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