Treatable Leukoencephalopathy in a Patient with Hypophosphatemia

Abstract

We report the first patient with pathologically proven leukoencephalopathy associated with hypophosphatemia. A 61-year-old woman had repetitive episodes of decreased consciousness with pontine and pallidal lesions and extensive leukoencephalopathy on MRI, later found to be associated with hypophosphatemia. Although hypophosphatemia has been linked to central pontine and extrapontine myelinolysis (osmotic myelinolysis), lesions in the deep white matter have not been reported. Brain biopsy performed during the first diagnosis process revealed nonspecific demyelination with gliosis, a finding similar to that of chronic osmotic myelinolysis. After normalization of phosphate levels, her consciousness completely improved and MRI abnormalities partly resolved. We should consider that leukoencephalopathy can be associated with hypophosphatemia, which is often treatable.

Phosphate in the Context of Cognitive Impairment and Other Neurological Disorders Occurrence in Chronic Kidney Disease

“…A study on hypophosphatemia after nontraumatic intracranial hemorrhage showed that acute hydrocephalus and diffuse brain edema were more common in patients with hypophosphatemia; however, there was no difference in outcome between hypophosphatemic and normophosphatemic patients [109]. Hypophosphatemia can also cause leukoencephalopathy, which can be corrected with treatment [110]. Other neurological illnesses, such as osmotic demyelination syndrome, have been described to be also associated with hypophosphatemia [111].…”

Elektrolitų Balanso Sutrikimai Ir Neurologinė Patologija

“…Sunorminus fosfatų kiekį kraujo serume, sąmonės pritemimo epizodai nesikartojo, MRT pokyčiai išnyko. Hipofosfatemija gali sąlygoti leukoencefalopatiją, kurią galima koreguoti [28]. Klinikinis atvejis: 58 metų vyras, sergantis užleista stemplės karcinoma, sukėlusia užpakalinės grįžtamos encefalopatijos sindromą (UGES).…”