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Diffuse Leukoencephalopathy Associated with Dialysis Disequilibrium Syndrome
Ryuichiro Hayashi1, Kozo Kitazawa, Daisuke Sanada
1Department of Neurology, Yokohama Municipal Citizen's Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|November 3, 2015
Summary
A gastric cancer patient on hemodialysis experienced a prolonged coma and white matter lesions, likely due to dialysis disequilibrium syndrome exacerbated by prior chemotherapy.
Area of Science:
- Nephrology
- Neurology
- Oncology
Background:
- A 52-year-old woman with a history of gastric cancer initiated hemodialysis for severe acidemia.
- Cancer chemotherapy can potentially affect neurological function.
Observation:
- Following hemodialysis, the patient experienced a ten-day coma.
- Neuroimaging revealed diffuse leukoencephalopathy with characteristic changes on MRI and MRS.
Findings:
- Transient cerebral white matter lesions, suspected interstitial edema, were diagnosed.
- These findings were attributed to dialysis disequilibrium syndrome (DDS).
- Chemotherapy history may have amplified DDS and contributed to subclinical brain injury.
Implications:
- Dialysis disequilibrium syndrome can manifest with severe neurological complications.
- Past chemotherapy is a potential risk factor for exacerbated DDS in dialysis patients.
- Close neurological monitoring is crucial for cancer survivors undergoing hemodialysis.
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