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Age Ageing ; 44(5): 898-900, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26209689

RESUMEN

An 84-year-old lady was treated for hyperosmolar hyperglycaemia with IV insulin, fluids and catheterisation for fluid balance monitoring. Trial without catheter failed as the patient complained of new-onset urinary incontinence and lack of awareness of bladder filling. In light of her breast cancer history, we excluded cauda equina. Ultrasound KUB showed an enlarged bladder. Whole-body MRI revealed a lesion in the pons which was highly suggestive of central pontine myelinolysis (CPM). Her electrolytes were normal throughout her admission; thus, the rapid fluctuation in osmolality, secondary to her hyperglycaemic state, was the likely cause of CPM. CPM has been reported secondary to hyperglycaemia; however, this is the first reported case of CPM presenting as urinary incontinence and loss of bladder sensation.


Asunto(s)
Coma Hiperglucémico Hiperosmolar no Cetósico/complicaciones , Mielinólisis Pontino Central/etiología , Incontinencia Urinaria/etiología , Administración Intravenosa , Anciano de 80 o más Años , Femenino , Fluidoterapia , Humanos , Coma Hiperglucémico Hiperosmolar no Cetósico/diagnóstico , Coma Hiperglucémico Hiperosmolar no Cetósico/terapia , Hipoglucemiantes/administración & dosificación , Insulina/administración & dosificación , Imagen por Resonancia Magnética , Mielinólisis Pontino Central/diagnóstico , Incontinencia Urinaria/diagnóstico , Imagen de Cuerpo Entero
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