TY - JOUR T1 - Occult central pontine myelinolysis post liver transplant: A consequence of pre-transplant hyponatremia JO - Annals of Hepatology T2 - AU - Zhu,Julie AU - Al-Alkim,Fatema AU - Hussaini,Trana AU - Vertinsky,Alexandra AU - Byrne,Danielle AU - Erb,Siegfried R. AU - Stoessl,A. Jon AU - Yoshida,Eric M. SN - 16652681 M3 - 10.1016/j.aohep.2019.01.004 DO - 10.1016/j.aohep.2019.01.004 UR - https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-occult-central-pontine-myelinolysis-post-S1665268119300547 AB - Rapid overcorrection of chronic hyponatremia can lead to osmotic demyelination syndrome or central pontine myelinolysis (CPM), a diagnosis often triggered by observing the characteristics of neurological abnormalities developed as a result of CPM. However, anyone with chronic hyponatremia and overcorrection of serum sodium is at risk of physiological CPM despite the lack of clinical symptoms. We report an adult patient who presented as post-op delirium, had incidental finding of CPM by magnetic resonance imaging (MRI) of the head after a liver transplant. Despite his non-typical presentation, the patient had the typical risk factors of CPM such as chronic hyponatremia, rapid overcorrection of serum sodium and cirrhosis undergoing a transplant. As hyponatremia and neurological disorder such encephalopathy simultaneously affect patients with cirrhosis, CPM may be more common than once thought in the chronic liver disease population and inappropriate hyponatremia management has important medical consequences that can go unnoticed. ER -