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Medicina Interna
versão impressa ISSN 0872-671X
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FERNANDES, Melissa Alexandre et al. Mielinólise Centropôntica e Extrapôntica: Experiência de um Centro de Transplante HepáticoCentral Pontine and Extrapontine Myelinolysis: Experience from a Single Liver Transplantation Center. Medicina Interna [online]. 2017, vol.24, n.2, pp.119-123. ISSN 0872-671X.
Introduction:Central pontine and extrapontine myelinolysis (CPEPM) is a rare demyelinating syndrome. It has been observed to be more prevalent in liver transplant recipients, with worse prognosis. Rapid corrections of hyponatremia and immunosuppressive agents, such as calcineurin inhibitors, have been pointed as possible causes for the development of this pathology. Methods:The authors report a review of five patients that underwent liver transplantation. Upon admission in the intensive care unit, they developed neurological signs and symptoms identified through brain magnetic resonance imaging, compatible with CPEPM, illustrated in a simple chart. Results:Heavy ethanol consumption, hepatic encephalopathy syndrome and hyponatremia were the most common features previous to the surgical procedure. Four of the five patients presented intra-operative serum sodium variation above the recommended values. Conclusion:The authors reviewed the documented cases of CPEPM in a liver transplantation reference centre, in order to evaluate the prevalence, clinical presentation and outcomes of this condition
Palavras-chave : Hyponatremia; Liver Transplantation; Myelinolysis; Central Pontine.