RESUMEN
We report a case of a 20-year-old African-American female, hospitalized and treated for hyperemesis gravidarum and hypokalemia with a normal serum sodium level. Two to 3 days into her hospitalization, she developed urinary incontinence, weakness, and pain in her lower extremities. An MRI brain scan showed central pontine signal alteration, leading to a diagnosis of CPM. A 4-month follow-up MRI brain scan showed complete resolution of the central pontine signal, with symptomatic improvement manifested by resolution of urinary incontinence and increased strength. Our case describes CPM occurring secondary to hypokalemia, with resolution of characteristic MRI findings at follow-up. Sole hypokalemia-induced CPM is very rare. What makes our patient even more unique is the complete resolution of the central pontine lesion on follow-up MRI. The cause of this cannot be completely explained and warrants further study.
Asunto(s)
Hipopotasemia/complicaciones , Imagen por Resonancia Magnética , Mielinólisis Pontino Central/etiología , Adulto , Encéfalo/patología , Diagnóstico Diferencial , Femenino , Humanos , Hiperemesis Gravídica/sangre , Hipopotasemia/sangre , Mielinólisis Pontino Central/diagnóstico , Embarazo , Complicaciones del Embarazo/sangre , Sodio/sangreAsunto(s)
Ascitis/cirugía , Hepatitis C Crónica/complicaciones , Hernia Umbilical/etiología , Cirrosis Hepática/complicaciones , Derivación Portosistémica Intrahepática Transyugular/efectos adversos , Diagnóstico Diferencial , Femenino , Hernia Umbilical/diagnóstico , Hernia Umbilical/cirugía , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias/etiologíaRESUMEN
This article explores the history of lupus erythematosus from the origins of the name to the most modern therapeutic advances. The review includes information about the origin of the name "lupus," the first clear description of the skin lesions, the discovery of the systemic and discoid forms, and further advances which define our current view of this illness. The classical descriptions of Hippocrates, Paracelsus, Manardi, Rudolph Virchow, Cazenave, Robert Willan, and Moritz Kaposi are chronologically described. Later, the contributions of Sir William Osler, Jonathan Hutchinson, Sequira and Balean, Kraus and Bohac, Libman and Sacks, Malcolm Hargraves, and Edmund L. Dubois are highlighted. The major breakthroughs of the modern period, including the diagnostic tests, animal models, and genetics, are briefly described. The article ends with the history of drug-induced lupus, diagnostic criteria, and the history of the therapy of lupus erythematosus. With modern therapeutic advances, the mortality rate from lupus erythematosus has decreased substantially. It is hoped that current research will further improve the prognosis of this disease in the near future.