Central pontine myelinolysis after liver transplantation: case report
Vol. 33 No. 3 (2017), Clinical Cases
Vol. 33 No. 3 (2017)

Central pontine myelinolysis after liver transplantation: case report

Clinical Cases
https://doi.org/10.22379/24224022150
Published 2017-01-01
Federico A Silva Sieger
MD, MSc, Neurologist and Clinical Epidemiologist; director Grupo de Ciencias Neurovasculares, Fundación Cardiovascular de Colombia, Santander, Colombia
Adriana M. Serrano-Martínez
MD, Clinical Research Fellow in Neurosciences, Fundación Cardiovascular de Colombia, Santander, Colombia
Alberto Castillo
MD, Clinical Research Fellow in Neurosciences, Fundación Cardiovascular de Colombia, Santander, Colombia
Mauricio Vanegas Ballesteros
MD, Transplant Surgeon; director of Hepatic Transplant Program; Fundación Cardiovascular de Colombia, Santander, Colombia
Tania Paola Cote Florez
MD, Emergency Department, Fundación Cardiovascular de Colombia, Santander, Colombia
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Keywords

Central pontine myelinolysis
hepatic encephalopathy
liver transplantation
hydroelectrolitic disturbances
immunosuppressants
critical care
(MeSH)

Abstract

Central Pontine Myelinolysis (CPM) is a demyelinating disease with central pontine localization which presents in patients with chronic hepatic disease and hydroelectrolytic disturbances. In spite of pathophysiology still unknown, the patient liver transplanted has several risk factors to CPM. Its clinical manifestations are mainly motor and awareness alterations. Diagnosis requires brain images like magnetic resonance and it has a poor prognosis in critical care patients and it is very important to know about the possibility of presentation and to be aware about this pathology. The main objective to present this case report is sensitizing the medical community regarding the CPM in patients with liver transplant. The case report of a 40-year-old female patient who had previous history of biliary cirrhosis secondary to autoimmune hepatitis and liver transplantation was performed; subsequently developed alteration of awareness, hydroelectrolytic disturbances and abnormal findings in brain imaging. CPM is a neurological demyelinating disease with multifactorial origin, its treatment is supportive and prevention is the main goal in patients with risk factors like patient after liver transplantation.

https://doi.org/10.22379/24224022150

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