Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Diffuse Leukoencephalopathy Associated with Dialysis Disequilibrium Syndrome
Ryuichiro HayashiKozo KitazawaDaisuke SanadaNoriyuki KatoTakafumi OhkoshiYasushi KatsumataShigeki Yamaguchi
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JOURNALS OPEN ACCESS

2015 Volume 54 Issue 21 Pages 2753-2758

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Abstract

A 52-year-old woman, previously treated for gastric cancer, began hemodialysis (HD) to treat the onset of severe acidemia. After her initial HD sessions, she suffered from a prolonged coma for approximately ten days. Magnetic resonance imaging revealed diffuse leukoencephalopathy, with increased apparent diffusion coefficient. Magnetic resonance spectroscopy showed a reduction of the N-acetylaspartate/creatine ratio. Her neuroimaging findings gradually resolved. Her transient cerebral white matter lesions were thought to be interstitial edema derived from dialysis disequilibrium syndrome (DDS), which might have been amplified by subclinical brain injury due to past chemotherapy. Her history of cancer chemotherapy may be a risk factor for an exacerbation of DDS.

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© 2015 by The Japanese Society of Internal Medicine
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