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- Kazuki Sakurai, Hajime Ikenouchi, Naoki Yamamoto, Kyohei Furuta, Ryo Ogawa, and Kaoru Endo.
- Division of Neurology, Sendai City Hospital, Japan.
- Intern. Med. 2023 May 1; 62 (9): 135113531351-1353.
AbstractAn 81-year-old woman was hospitalized with progressive consciousness disturbance. Blood tests showed acidemia with severe renal dysfunction, and a cerebral spinal fluid (CSF) test showed pleocytosis with myelin basic protein (MBP) elevation. Brain magnetic resonance imaging showed unilaterally dominant subcortical white matter lesions with lentiform fork sign on T2-weighted imaging. After initiating hemodialysis, her consciousness disturbance and white matter lesions improved, suggesting uremic encephalopathy (UE). Unilaterally dominant leukoencephalopathy and high pleocytosis with MBP elevation in CSF are less common than previously identified characteristics of UE. When unilateral leukoencephalopathy occurs in patients with renal failure, UE should be considered.
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