ReVersible MRI Changes in a Patient with Uremic Encephalopathy.
- Author:
Min Hwa JANG
1
;
Hyuk Joon CHOI
;
Ji Hyung CHO
;
Hyeog Man KWON
;
Chan Duck KIM
;
Sun Hee PARK
;
Dong Kyu CHO
;
Yong Lim KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Kyungpook University, Daegu, Korea. ylkim@knu.ac.kr
- Publication Type:Case Report
- Keywords:
Uremic encephalopathy;
MRI;
Adequacy
- MeSH:
Brain;
Creatinine;
Diabetic Nephropathies;
Dysarthria;
Follow-Up Studies;
Gait;
Globus Pallidus;
Humans;
Magnetic Resonance Imaging*;
Metabolism;
Middle Aged;
Peritoneal Dialysis;
Peritoneal Dialysis, Continuous Ambulatory;
Putamen;
Uremia
- From:Korean Journal of Nephrology
2003;22(5):618-621
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Uremic encephalopathy is a well-known complication in uremia and may result from changes of cerebral metabolism due to uremic toxins. Specific morphological changes have not been observed and pathogenesis is still unclear. We experienced a case with uremic encephalopathy in whom reVersible abnormalities were observed on brain magnetic resonance image (MRI). A 61-year-old man with chronic renal faliure due to diabetic nephropathy started automated peritoneal dialysis (APD) one year ago (therapy time: 10 hours, number of cycles: 5, fill volume per cycle: 2 L). He developed gait disturbance and dysarthria after he dwelled icodextrin contained 2 L dialysate over night instead of APD. In that time, his weekly Kt/V and creatinine clearance were 1.5 and 87.5 L/week/1.73 m2, respectively. On brain MRI, low signal in T1 image and high signal in T2 image were seen in putamen and globus pallidus bilaterally. Insufficient peritoneal dialysis adequacy was documented, and the patient was switched from APD to continuous ambulatory peritoneal dialysis (CAPD). After than, his symptom gradually improved. On follow-up MRI 2 months later, previous lesion has disappeared.
