Fatemeh Yaghoubi
1 
, Davood Babakhani
2 , Farnoosh Tavakoli
3 , Farnaz Tavakoli
1* 1 Nephrology and Kidney Transplantation Ward, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Hematology, Oncology Research Center and Stem Cell Transplantation (HORCST), Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Endocrinology and Metabolism Research Institute (EMRI), Tehran University of Medical Sciences, Tehran, Iran
Abstract
A 14-year-old boy with a past medical history of bone marrow transplantation (BMT) was referred to the emergency department with the loss of consciousness and seizure. On admission, the blood test indicated strict hyponatremia with hypokalemia, hypomagnesemia, hypophosphatemia, hypoglycemia, and low-serum low-density lipoprotein cholesterol (LDL-C). After six days, the patient suffered from dysarthria, dysphagia, behavioral disturbances, disorientation, and obtundation. Based on the physical examination, hyperreflexia and upward bilateral plantar reflexes were outstanding. Lumbar puncture, spiral brain CT scan, and MRI were normal. Hence, MRI repeated 2 weeks later, and the T2-weighted image indicated the bilateral symmetric hyperintense lesions in the basal ganglia. The osmotic demyelination syndrome (ODS) is a scarce and serious neurologic complication of the quick correction of chronic strict hyponatremia.
Implication for health policy/practice/research/medical education:
Osmotic demyelination syndrome risk is highest in the patients with serum sodium of ≤120 mEq/L, especially if hyponatremia is associated with hypokalemia, low-plasma osmolality and other electrolyte disorders.
Please cite this paper as: Babakhani D, Yaghoubi F, Tavakoli F, Tavakoli F. Osmotic demyelination syndrome after bone marrow transplantation. J Nephropathol. 2022;11(1):e10. DOI: 10.34172/jnp.2022.10.