Dialysis disequilibrium syndrome induced by neoplastic meningitis in a patient receiving maintenance hemodialysisReport as inadecuate




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BMC Nephrology

, 14:255

Dialysis and Transplantation

Abstract

BackgroundDialysis disequilibrium syndrome is characterized by neurological symptoms resulting from cerebral edema, which occurs as a consequence of hemodialysis. Dialysis disequilibrium syndrome most often occurs in patients who have just started hemodialysis, during hemodialysis, or soon after hemodialysis; although it may also occur in patients who are under maintenance hemodialysis with pre-existing neurological disease.

Case presentationA 70-year-old woman, who had been receiving maintenance hemodialysis for one year, was diagnosed with ovarian cancer by ascites cytological examination. Two years later, she reported severe headache and nausea during hemodialysis and was diagnosed with dialysis disequilibrium syndrome. Although brain images revealed mild hydrocephalus without any mass lesions, poorly differentiated adenocarcinoma cells were detected in her cerebrospinal fluid. These findings indicated that DDS was induced by neoplastic meningitis due to ovarian cancer metastasis.

ConclusionNeoplastic meningitis should be considered and excluded in hemodialysis patients with dialysis disequilibrium syndrome and malignancy by cytological examination of the cerebrospinal fluid even if cerebral imaging shows no obvious lesions. This is the first reported case of dialysis disequilibrium syndrome induced by neoplastic meningitis in a patient receiving maintenance hemodialysis.

KeywordsDialysis disequilibrium syndrome Hemodialysis Neoplastic meningitis AbbreviationsCKDChronic kidney disease

CSFCerebrospinal fluid

DDSDialysis disequilibrium syndrome

MRIMagnetic resonance imaging

NMNeoplastic meningitis

NSFNephrogenic systemic fibrosis

WBCWhite blood cell.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2369-14-255 contains supplementary material, which is available to authorized users.

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Author: Yohei Tsuchida - Takuma Takata - Toshihiko Ikarashi - Noriaki Iino - Junichiro J Kazama - Ichiei Narita

Source: https://link.springer.com/



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