托伐普坦纠正低钠血症导致渗透性脱髓鞘综合征1例并文献复习

A Case of Tolvaptan-Induced Osmotic Demyelination Syndrome Secondary to Correcting Hyponatremia: A Literature Review

摘要: 目的：报道托伐普坦纠正低钠血症导致渗透性脱髓鞘综合征1例，探讨托伐普坦会过快纠正低钠血症时会导致患者发生渗透性脱髓鞘综合征的可能性，以及渗透性脱髓鞘综合征的患者，其影像学改变往往迟于其临床表现。方法：我院收治1例服用托伐普坦后导致低钠血症被过快纠正进一步出现渗透性脱髓鞘综合征。结论：遵循指南推荐剂量服用托伐普坦，在纠正低钠血症后有出现渗透性脱髓鞘综合征的可能，以及对于这一类患者而言，神经影像学在早期诊断中与临床表现并不具备很好的相关性。

Abstract: Introduction: The purpose of this study is to examine the potential risk of tolvaptan-induced os-motic demyelination syndrome in patients when correcting hyponatremia too rapidly. Additionally, we aim to evaluate the correlation between the timing of radiological changes and clinical manifes-tations in patients with osmotic demyelination syndrome. Methods: A single case of a patient who developed osmotic demyelination syndrome as a consequence of rapid correction of hyponatremia caused by tolvaptan treatment is presented. The patient’s clinical history, laboratory data, imaging findings, and clinical course are described. Conclusion: Our findings suggest that there is a possibil-ity of osmotic demyelination syndrome occurring in patients when correcting hyponatremia too rapidly with tolvaptan. Furthermore, the radiological changes in patients with osmotic demye-lination syndrome often lag behind their clinical manifestations, emphasizing the importance of clinical assessment and monitoring in early diagnosis and management of this condition.