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Medicina & Laboratorio

2013, Número 11-12

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Medicina & Laboratorio 2013; 19 (11-12)


Síndrome de desmielinización osmótica. Presentación de un caso y revisión de tema

Núñez CEE, Ramírez RA, Moreno GL

Idioma: Español
Referencias bibliográficas: 64
Paginas: 577-589
Archivo PDF: 547.58 Kb.


RESUMEN

El síndrome de desmielinización osmótica es una complicación neurológica poco frecuente. Se ha descrito, principalmente en pacientes que se les realiza correcciones rápidas en sus niveles de sodio sérico, por lo cual, siempre se debe ser cauto a la hora de corregir trastornos hidroelectrolíticos en los pacientes que consultan al servicio de urgencia. Sin embargo, se han reportado casos asociados de desmielinización osmótica sin correcciones de hiponatremias, por lo que se debe tener un bajo umbral diagnóstico para sospecharlo, por las consecuencias neurológicas asociadas y la ausencia de tratamiento efectivo. A continuación presentamos un caso clínico de una paciente que presentó un episodio de desmielinización osmótica extrapontica al parecer sin secuelas. Adicionalmente se hace una revisión completa del tema.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Adams RD, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. AMA Arch Neurol Psychiatry 1959; 81: 154-172.

  2. Pearce JM. Central pontine myelinolysis. Eur Neurol 2009; 61: 59-62.

  3. Kleinschmidt-DeMasters BK, Norenberg MD. Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis. Science 1981; 211: 1068-1070.

  4. Kleinschmidt-Demasters BK, Rojiani AM, Filley CM. Central and extrapontine myelinolysis: then...and now. J Neuropathol Exp Neurol 2006; 65: 1-11.

  5. Tomlinson BE, Pierides AM, Bradley WG. Central pontine myelinolysis. Two cases with associated electrolyte disturbance. Q J Med 1976; 45: 373-386.

  6. Ashrafian H, Davey P. A review of the causes of central pontine myelinosis: yet another apoptotic illness? Eur J Neurol 2001; 8: 103-109.

  7. Murase T, Sugimura Y, Takefuji S, Oiso Y, Murata Y. Mechanisms and therapy of osmotic demyelination. Am J Med 2006; 119: S69-73.

  8. Wright DG, Laureno R, Victor M. Pontine and extrapontine myelinolysis. Brain 1979; 102: 361-385.

  9. Pirzada NA, Ali, II. Central pontine myelinolysis. Mayo Clin Proc 2001; 76: 559-562.

  10. Gocht A, Colmant HJ. Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropathol 1987; 6: 262-270.

  11. Tsutsumi S, Yasumoto Y, Ito M. Central pontine and extrapontine myelinolysis in an infant associated with the treatment of craniopharyngioma: case report. Neurol Med Chir (Tokyo) 2008; 48: 351-354.

  12. King JD, Rosner MH. Osmotic demyelination syndrome. Am J Med Sci 2010; 339: 561-567.

  13. Newell KL, Kleinschmidt-DeMasters BK. Central pontine myelinolysis at autopsy; a twelve year retrospective analysis. J Neurol Sci 1996; 142: 134-139.

  14. Shah SO, Wang A, Mudambi L, Ghuznavi N, Fekete R. Asymptomatic central pontine myelinolysis: a case report. Case Rep Neurol 2012; 4: 167-172.

  15. Singh N, Yu VL, Gayowski T. Central nervous system lesions in adult liver transplant recipients: clinical review with implications for management. Medicine (Baltimore) 1994; 73: 110-118.

  16. Burns JD, Kosa SC, Wijdicks EF. Central pontine myelinolysis in a patient with hyperosmolar hyperglycemia and consistently normal serum sodium. Neurocrit Care 2009; 11: 251-254.

  17. Cardenas JF, Bodensteiner JB. Osmotic demyelination syndrome as a consequence of treating hyperammonemia in a patient with ornithine transcarbamylase deficiency. J Child Neurol 2009; 24: 884-886.

  18. McComb RD, Pfeiffer RF, Casey JH, Wolcott G, Till DJ. Lateral pontine and extrapontine myelinolysis associated with hypernatremia and hyperglycemia. Clin Neuropathol 1989; 8: 284-288.

  19. Guerrero WR, Dababneh H, Nadeau SE. Hemiparesis, encephalopathy, and extrapontine osmotic myelinolysis in the setting of hyperosmolar hyperglycemia. J Clin Neurosci 2013; 20: 894-896.

  20. Sutamnartpong P, Muengtaweepongsa S, Kulkantrakorn K. Wernicke’s encephalopathy and central pontine myelinolysis in hyperemesis gravidarum. J Neurosci Rural Pract 2013; 4: 39-41.

  21. Adrogue HJ, Madias NE. Hyponatremia. N Engl J Med 2000; 342: 1581-1589.

  22. Kim JG, Son YJ, Yun CH, Kim YI, Nam-Goong IS, Park JH, et al. Thyroid transcription factor-1 facilitates cerebrospinal fluid formation by regulating aquaporin- 1 synthesis in the brain. J Biol Chem 2007; 282: 14923-14931.

  23. Papadopoulos MC, Verkman AS. Aquaporin-4 and brain edema. Pediatr Nephrol 2007; 22: 778-784.

  24. Suzuki R, Okuda M, Asai J, Nagashima G, Itokawa H, Matsunaga A, et al. Astrocytes co-express aquaporin- 1, -4, and vascular endothelial growth factor in brain edema tissue associated with brain contusion. Acta Neurochir Suppl 2006; 96: 398-401.

  25. Pasantes-Morales H, Lezama RA, Ramos-Mandujano G, Tuz KL. Mechanisms of cell volume regulation in hypo-osmolality. Am J Med 2006; 119: S4-11.

  26. Verbalis JG. Hyponatremia: epidemiology, pathophysiology, and therapy. Curr Opin Nephrol Hypertens 1993; 2: 636-652.

  27. Ayus JC, Armstrong DL, Arieff AI. Effects of hypernatraemia in the central nervous system and its therapy in rats and rabbits. J Physiol 1996; 492 ( Pt 1): 243- 255.

  28. DePasquale M, Patlak CS, Cserr HF. Brain ion and volume regulation during acute hypernatremia in Brattleboro rats. Am J Physiol 1989; 256: F1059-1066.

  29. Lien YH, Shapiro JI, Chan L. Effects of hypernatremia on organic brain osmoles. J Clin Invest 1990; 85: 1427-1435.

  30. Ayus JC, Achinger SG, Arieff A. Brain cell volume regulation in hyponatremia: role of sex, age, vasopressin, and hypoxia. Am J Physiol Renal Physiol 2008; 295: F619-624.

  31. Verbalis JG, Gullans SR. Hyponatremia causes large sustained reductions in brain content of multiple organic osmolytes in rats. Brain Res 1991; 567: 274- 282.

  32. Adler S, Verbalis JG, Williams D. Effect of rapid correction of hyponatremia on the blood-brain barrier of rats. Brain Res 1995; 679: 135-143.

  33. Love S. Demyelinating diseases. J Clin Pathol 2006; 59: 1151-1159.

  34. Uchino A, Yuzuriha T, Murakami M, Endoh K, Hiejima S, Koga H, et al. Magnetic resonance imaging of sequelae of central pontine myelinolysis in chronic alcohol abusers. Neuroradiology 2003; 45: 877-880.

  35. Brown WD. Osmotic demyelination disorders: central pontine and extrapontine myelinolysis. Curr Opin Neurol 2000; 13: 691-697.

  36. Lien YH. Role of organic osmolytes in myelinolysis. A topographic study in rats after rapid correction of hyponatremia. J Clin Invest 1995; 95: 1579-1586.

  37. Sterns RH, Silver SM. Brain volume regulation in response to hypo-osmolality and its correction. Am J Med 2006; 119: S12-16.

  38. Lohr JW. Osmotic demyelination syndrome following correction of hyponatremia: association with hypokalemia. Am J Med 1994; 96: 408-413.

  39. Riggs JE, Hogg JP. Central pontine myelinolysis: association with parenteral magnesium administration. Mil Med 2000; 165: 494-495.

  40. Soupart A, Silver S, Schrooeder B, Sterns R, Decaux G. Rapid (24-hour) reaccumulation of brain organic osmolytes (particularly myo-inositol) in azotemic rats after correction of chronic hyponatremia. J Am Soc Nephrol 2002; 13: 1433-1441.

  41. Huang WY, Weng WC, Peng TI, Ro LS, Yang CW, Chen KH. Central pontine and extrapontine myelinolysis after rapid correction of hyponatremia by hemodialysis in a uremic patient. Ren Fail 2007; 29: 635-638.

  42. McKee AC, Winkelman MD, Banker BQ. Central pontine myelinolysis in severely burned patients: relationship to serum hyperosmolality. Neurology 1988; 38: 1211-1217.

  43. Grech R, Galvin L, Brennan P, Thornton J. Central pontine myelinolysis. BMJ Case Rep 2013; 2013.

  44. de Souza A. Movement disorders and the osmotic demyelination syndrome. Parkinsonism Relat Disord 2013; 19: 709-716.

  45. Martin RJ. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes. J Neurol Neurosurg Psychiatry 2004; 75 Suppl 3: iii22-28.

  46. Menger H, Jorg J. Outcome of central pontine and extrapontine myelinolysis (n = 44). J Neurol 1999; 246: 700-705.

  47. Messert B, Orrison WW, Hawkins MJ, Quaglieri CE. Central pontine myelinolysis. Considerations on etiology, diagnosis, and treatment. Neurology 1979; 29: 147-160.

  48. Miller GM, Baker HL, Jr., Okazaki H, Whisnant JP. Central pontine myelinolysis and its imitators: MR findings. Radiology 1988; 168: 795-802.

  49. Martin PJ, Young CA. Central pontine myelinolysis: clinical and MRI correlates. Postgrad Med J 1995; 71: 430-432.

  50. Yuh WT, Simonson TM, D’Alessandro MP, Smith KS, Hunsicker LG. Temporal changes of MR findings in central pontine myelinolysis. AJNR Am J Neuroradiol 1995; 16: 975-977.

  51. Nair SR, Ramli NM, Rahmat K, Mei-Ling ST. Central pontine and extrapontine myelinolysis: Diffusion weighted imaging and diffusion tensor imaging on follow-up. Neurol India 2012; 60: 426-428.

  52. Min Y, Park SH, Hwang SB. Corticospinal tract and pontocerebellar fiber of central pontine myelinolysis. Ann Rehabil Med 2012; 36: 887-892.

  53. Verbalis JG, Goldsmith SR, Greenberg A, Schrier RW, Sterns RH. Hyponatremia treatment guidelines 2007: expert panel recommendations. Am J Med 2007; 120: S1-21.

  54. Zeltser D, Rosansky S, van Rensburg H, Verbalis JG, Smith N. Assessment of the efficacy and safety of intravenous conivaptan in euvolemic and hypervolemic hyponatremia. Am J Nephrol 2007; 27: 447-457.

  55. Walter KA. Conivaptan: new treatment for hyponatremia. Am J Health Syst Pharm 2007; 64: 1385-1395.

  56. Schrier RW, Gross P, Gheorghiade M, Berl T, Verbalis JG, Czerwiec FS, et al. Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. N Engl J Med 2006; 355: 2099-2112.

  57. Gankam Kengne F, Soupart A, Pochet R, Brion JP, Decaux G. Re-induction of hyponatremia after rapid overcorrection of hyponatremia reduces mortality in rats. Kidney Int 2009; 76: 614-621.

  58. Soupart A, Ngassa M, Decaux G. Therapeutic relowering of the serum sodium in a patient after excessive correction of hyponatremia. Clin Nephrol 1999; 51: 383-386.

  59. Yamada H, Takano K, Ayuzawa N, Seki G, Fujita T. Relowering of serum na for osmotic demyelinating syndrome. Case Rep Neurol Med 2012; 2012: 704639.

  60. Oh MS, Choi KC, Uribarri J, Sher J, Rao C, Carroll HJ. Prevention of myelinolysis in rats by dexamethasone or colchicine. Am J Nephrol 1990; 10: 158-161.

  61. Bibl D, Lampl C, Gabriel C, Jungling G, Brock H, Kostler G. Treatment of central pontine myelinolysis with therapeutic plasmapheresis. Lancet 1999; 353: 1155.

  62. Decaux G, Soupart A. Treatment of symptomatic hyponatremia. Am J Med Sci 2003; 326: 25-30.

  63. McCormick WF, Danneel CM. Central pontine myelinolysis. Arch Intern Med 1967; 119: 444-478.

  64. Louis G, Megarbane B, Lavoue S, Lassalle V, Argaud L, Poussel JF, et al. Long-term outcome of patients hospitalized in intensive care units with central or extrapontine myelinolysis*. Crit Care Med 2012; 40: 970-972.




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