Central Pontine Myelinolysis in a Patient with Acute Lymphoblastic Leukemia after Hematopoietic Stem Cell Transplantation: A Case Report.
10.3346/jkms.2008.23.2.324
- Author:
Kyu Hyoung LIM
1
;
Sunyoung KIM
;
Yoon Su LEE
;
Ki Hwan KIM
;
Jinwon KIM
;
Ji Young RHEE
;
Hye Jin KIM
;
Hyeon Gyu YI
;
So Yeon OH
;
Joo Han LIM
;
Sae Won HAN
;
Sangyoon LEE
;
Inho KIM
;
Sung Soo YOON
;
Seonyang PARK
;
Byoung Kook KIM
Author Information
1. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. kim_dajung@hanmail.net
- Publication Type:Case Report
- Keywords:
Myelinolysis, Central Pontine;
Hematopoietic Stem Cell Transplantation;
Graft versus Host Disease
- MeSH:
Adult;
Biopsy;
Brain/pathology;
Electroencephalography;
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation/*adverse effects;
Humans;
Hyperbilirubinemia/etiology;
Liver/pathology;
Magnetic Resonance Imaging;
Male;
Myelinolysis, Central Pontine/complications/*etiology;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/*therapy;
Time Factors;
Treatment Outcome
- From:Journal of Korean Medical Science
2008;23(2):324-327
- CountryRepublic of Korea
- Language:English
-
Abstract:
We describe a 37-yr-old man who developed central pontine myelinolysis (CPM) after allogeneic hematopoietic stem cell transplantation (HSCT) for acute lymphoblastic leukemia. After HSCT, desquamation developed on the whole body accompanied by hyperbilirubinemia. The liver biopsy of the patient indicated graft-versus-host disease- related liver disease, and the dose of methylprednisolone was increased. Then, the patient developed altered mentality with eye ball deviation to the left, for which electroencephalogram and magnetic resonance imaging (MRI) scans were done. Brain MRI scan demonstrated the imaging findings consistent with central pontine myelinolysis and extrapontine myelinolysis. He did not have any hyponatremia episode during hospitalization prior to the MRI scan. To the best of our knowledge, presentation of CPM after allogeneic HSCT is extremely rare in cases where patients have not exhibited any episodes of significant hyponatremia. We report a rare case in which hepatic dysfunction due to graft-versus-host disease has a strong association with CPM after HSCT.
