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Case Report
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| A unique case of neurological manifestation of hemolytic uremic syndrome which responded to the treatment with intravenous magnesium sulfate | ||||||
| Anza Memon1, Salman Rashid2, Mitchel T. Williams3 | ||||||
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1MD, Senior Staff Neurologist, Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USA
2MD, Pediatric Neurologist, Department of Neurology, Wayne State University, Detroit Medical Center, Detroit, Michigan, USA 3MD, Department of Pediatrics & Neurology, Children’s Hospital of Michigan, Wayne State University, Detroit Michigan | ||||||
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| How to cite this article |
| Memon A, Rashid S, Williams MT. A unique case of neurological manifestation of hemolytic uremic syndrome which responded to the treatment with intravenous magnesium sulfate. Int J Case Rep Images 2017;8(5):326–330. |
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ABSTRACT
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Introduction:We describe a patient with central nervous system (CNS) manifestation of hemolytic uremic syndrome (HUS) presented with new onset seizure and focal cortical signs with reversible lesions involving the splenium of the corpus callosum (SCC) and evidence of reversible focal cerebral vasospasm (RFCV) on brain magnetic resonance angiogram (MRA) responsive to intravenous MgSO4. This is a rare case of neurological presentation of HUS which improved after treatment with high doses of magnesium sulfate (MgSO4). Case Report: A 13-year-old Caucasian female with HUS and positive stool test for Shiga toxin two was being managed with hemodialysis and subsequently with the plasma exchange (PLEX). Following her seventh cycle of PLEX the patient developed left gaze deviation and head version with generalized tonic stiffening. Conclusion: MgSO4 is an N-methyl aspartate (NMDA) receptor antagonist. Influx of calcium ions through NMDA receptor can lead to cerebral ischemic injury which can be reversible in the early stages of the disease process. Improvement of neurological symptoms in our patient after treatment with MgSO4 is a novel finding which has not been reported before in HUS. Keywords: Neuroprotective role of magnesium sulfate, Reversible focal cerebral vasospasm in hemolytic uremic syndrom, Neurology of hemolytic uremic syndrom, Splenium of corpus callosum lesions in hemolytic uremic syndrome |
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Author Contributions
Anza B. Memon – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Salman Rashid – Substantial contributions to conception and design, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Mitchel T. Williams – Substantial contributions to conception and design, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2017 Anza B. Memon et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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About the Authors
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