A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis
Authors: Karattuthodi Mohammed Salim, Ramsiya Saidalavi, Kainadan Fabin, Kizhissery Salman Faris, Aswathi Vijayan
Background: The fall of serum sodium concentration may happen in hyperemesis gravidarum and subsequently can result into hypotonic hyponatremia. This would cause water to move into the brain and develop cerebral edema manifested with neurologic symptoms. However, adaptive mechanism by brain would lower the cerebral volume to a normal range. On the other hand, rapid correction of chronic hyponatremia would damage the brain cells. The symptoms depicted because of rapid over correction of sodium is known as osmotic demyelination syndrome. Case Presentation: The pregnant lady with hyperemesis gravidarum went to severe hyponatremia. And further, she underwent dilatation and evacuation because of the intrauterine fetal death. The normal saline administered to correct the state of hyponatremia caused the patient to be in depression with catatonia and aphasia. The symptoms were correlated with osmotic demyelinolysis and the event was confirmed with magnetic resonance imaging of brain. Conclusion: The administration of sodium should be performed with utmost cautions and under the supervision of welltrained healthcare providers. Any sign or symptom of neurological abnormalities observed because of overcorrection should be considered seriously.
Keywords: Dyselectrolytemia, hyperemesis, hyponatremia, intrauterine fetal death, osmotic demyelinolysis
Authors
Karattuthodi Mohammed Salim
Assistant Professor, Department of Pharmacy Practice, Al Shifa College of Pharmacy, Affiliated to Kerala University of Health Sciences, India
Google Scholor Articles
Pubmed Articles
Ramsiya Saidalavi
PharmD Intern, Department of Pharmacy Practice, Al Shifa College of Pharmacy, Affiliated to Kerala University of Health Sciences, India
Google Scholor Articles
Pubmed Articles
Kainadan Fabin
PharmD Intern, Department of Pharmacy Practice, Al Shifa College of Pharmacy, Affiliated to Kerala University of Health Sciences, India
Google Scholor Articles
Pubmed Articles
Kizhissery Salman Faris
PharmD Intern, Department of Pharmacy Practice, Al Shifa College of Pharmacy, Affiliated to Kerala University of Health Sciences, India
Google Scholor Articles
Pubmed Articles
Correspondence to:
Mohammed Salim KT, Assistant Professor, Department of Pharmacy Practice, Al Shifa College of Pharmacy, Affiliated to Kerala University of Health Sciences, India mohammedsalimkt@alshifacollegeofpharmacy.ac.in
Publication history:
Received 26 Apr 2020
Revised 16 Feb 2021
Accepted 07 May 2021
Published online 02 Jul 2021
Published in print 25 Jul 2021
Salim KM, Saidalavi R, Fabin K, Faris KS, Vijayan A. A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis. EJMCR. 2021; 5(7): 191-196. doi:
10.24911/ejmcr/173-1587876972
Salim KM, Saidalavi R, Fabin K, Faris KS, Vijayan A. A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis. https://www.ejmcr.com/?mno=102185 [Access: April 25, 2024]. doi:
10.24911/ejmcr/173-1587876972
Salim KM, Saidalavi R, Fabin K, Faris KS, Vijayan A. A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis. EJMCR. 2021; 5(7): 191-196. doi:
10.24911/ejmcr/173-1587876972
Salim KM, Saidalavi R, Fabin K, Faris KS, Vijayan A. A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis. EJMCR. (2021), [cited April 25, 2024]; 5(7): 191-196. doi:
10.24911/ejmcr/173-1587876972
Salim, K. M., Saidalavi, . R., Fabin, . K., Faris, . K. S. & Vijayan, . A. (2021) A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis. EJMCR, 5 (7), 191-196. doi:
10.24911/ejmcr/173-1587876972
Salim, Karattuthodi Mohammed, Ramsiya Saidalavi, Kainadan Fabin, Kizhissery Salman Faris, and Aswathi Vijayan. 2021. A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis. European Journal of Medical Case Reports, 5 (7), 191-196. doi:
10.24911/ejmcr/173-1587876972
Salim, Karattuthodi Mohammed, Ramsiya Saidalavi, Kainadan Fabin, Kizhissery Salman Faris, and Aswathi Vijayan. "A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis." European Journal of Medical Case Reports 5 (2021), 191-196. doi:
10.24911/ejmcr/173-1587876972
Salim, Karattuthodi Mohammed, Ramsiya Saidalavi, Kainadan Fabin, Kizhissery Salman Faris, and Aswathi Vijayan. "A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis." European Journal of Medical Case Reports 5.7 (2021), 191-196. Print. doi:
10.24911/ejmcr/173-1587876972
Salim, K. M., Saidalavi, . R., Fabin, . K., Faris, . K. S. & Vijayan, . A. (2021) A case report of pregnant lady with hyperemesis gravidarum that led to osmotic demyelinolysis. European Journal of Medical Case Reports, 5 (7), 191-196. doi:
10.24911/ejmcr/173-1587876972