Preview

Russian neurological journal

Advanced search

Acute uremic polyneuropathy in a patient with Alzheimer’s disease

https://doi.org/10.30629/2658-7947-2022-27-6-84-88

Abstract

The article presents a case of acute uremic neuropathy. Without any visible cause, a 71-year-old patient felt weakness in legs and numbness in feet. Her neurological status assessment on admission to the hospital showed peripheral tetraparesis and impaired sensitivity of the polyneuropathic type. Neurological symptoms appeared due to renal dysfunction, which had been confi rmed with laboratory test. Electroneuromyography revealed signs of acute demyelinating polyneuropathy. Аt the hospital, the patient was diagnosed Alzheimer’s disease. The treatment provided at the hospital led to normalization of her laboratory parameters and complete restoration of motor functions. The peculiarity of the presented clinical case is that the patient started violating drinking regime due to her cognitive impairment which resulted in renal dysfunction and acute uremic neuropathy. The other peculiarity of the case is that it was enough to correct the water-electrolyte disorders to fully restore the patient’s motor functions within a month, without the use of dialysis. Finally, the article discusses the issue of pathogenesis and diff erential diagnosis of other types of polyneuropathies.

About the Authors

S. A. Mamykina
I.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of Russia
Russian Federation

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery

Moscow



V. V. Oganov
I.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of Russia
Russian Federation

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery

Moscow



O. N. Voskresenskaya
I.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of Russia
Russian Federation

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery

Moscow



V. V. Grinyuk
I.M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of Russia
Russian Federation

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery

Moscow



References

1. Camargo C., Schoueri J., Alves B., Veiga G., Fonseca F., Bacci M.R. Uremic neuropathy: an overview of the current literature. Revista da Associacao Medica Brasileira 2019;65(3):469– 474. https://doi.org/10.1590/1806-9282.65.3.469

2. Ho D.T., Rodig N.M., Kim H.B., Lidov H.G., Shapiro F.D., Raju G.P., Kang P.B. Rapid reversal of uremic neuropathy following renal transplantation in an adolescent. Pediatric transplantation. 2012;16(7):E296–E300. https://doi.org/10.1111/j.1399-3046.2011.01630.x

3. Baumgaertel M.W., Kraemer M., Berlit P. Neurologic complications of acute and chronic renal disease. Handbook of clinical neurology. 2014;119:383–393. https://doi.org/10.1016/B978-0-7020-4086-3.00024-2

4. Anand U., Korchev Y., Anand P. The role of urea in neuronal degeneration and sensitization: An in vitro model of uremic neuropathy. Molecular pain. 2019;15:1–12. https://doi.org/10.1177/1744806919881038

5. Hamed S.A. Neurologic conditions and disorders of uremic syndrome of chronic kidney disease: presentations, causes, and treatment strategies. Expert review of clinical pharmacology. 2019;12(1):61–90. https://doi.org/10.1080/17512433.2019.1555468

6. Ghazan-Shahi S., Koh T.J., Chan C.T. Impact of nocturnal hemodialysis on peripheral uremic neuropathy. BMC nephrology. 2015;16:134. https://doi.org/10.1186/s12882-015-0133-2

7. Said G. Uremic neuropathy. Handbook of clinical neurology. 2013;115:607–612. https://doi.org/10.1016/B978-0-444-52902-2.00035-7

8. Fedoseev A.N., Shestakov V.V., Vaulin I.N., Salnikova I.A. Uremic polyneuropathy therapy in patients subjected to chronic program hemodialysis. Perm Medical Zhurnal. 2012;29(3):29–35. (In Russ.).

9. Smyth B., Krishnan A.V., Gallagher M., Kiernan M., Snelling P., Hawley C. et al. Randomised controlled trial of the impact of haemodiafi ltration on uraemic neuropathy: FINESSE study protocol. BMJ open. 2019;9(1):e023736. https://doi.org/10.1136/bmjopen-2018-023736

10. Kumar J., Sharma S. Uremic autonomic neuropathy. Clinical Queries: Nephrology. 2014;3(1):15–19. https://doi.org/10.1016/j.cqn.2014.03.008

11. Mazza A., Lucchetta M., Torin G., Schiavon L., Sacco A.P., Villi G. et al. Hypertensive Crisis with Neurological Impairment Mimicking a Guillain–Barrè Syndrome: Searching for a Link. High blood pressure & cardiovascular prevention: the offi cial journal of the Italian Society of Hypertension. 2018;25(4):421– 424. https://doi.org/10.1007/s40292-018-0283-y

12. Bowley M.P., Ropper A.H. Neuropathies in Systemic Disease. Seminars in neurology. 2015;35(4):431–447. https://doi.org/10.1055/s-0035-1558978

13. Deger S.M., Reis K.A., Guz G., Bali M., Erten Y.A case of an accelerated uremic neuropathy. Renal failure. 2011;33(3):371–372. https://doi.org/10.3109/0886022X.2011.559677

14. Priti K., Ranwa B. Acute Fulminant Uremic Neuropathy Following Coronary Angiography Mimicking Guillain–Barre Syndrome. Heart views: the offi cial journal of the Gulf Heart Association. 2017;18(2):62–63. https://doi.org/10.4103/1995-705X.208673

15. Gilyarov M.Y., Belikova L.P., Shchukin I.A., Fidler M.S., Avakyan G.G., Shustrova G.E. et al. Neurological disorders in eosinophilic granulomatosis with polyangiitis (Churg–Strauss syndrome). Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2016;116 (10):93–102. (In Russ.). https://doi.org/10.17116/jnevro201611610193-102

16. Kim E.J., Shin D.H., Jeon H.J., Rhee S.Y., Nam E.S., Park J.Y., Oh J. A rare case of polyneuropathy and monoclonal gammopathy with recurrent acute kidney injury. Electrolyte & blood pressure: E & BP. 2016;14(1):5–10. https://doi.org/10.5049/EBP.2016.14.1.5


Review

For citations:


Mamykina S.A., Oganov V.V., Voskresenskaya O.N., Grinyuk V.V. Acute uremic polyneuropathy in a patient with Alzheimer’s disease. Russian neurological journal. 2022;27(6):84-88. (In Russ.) https://doi.org/10.30629/2658-7947-2022-27-6-84-88

Views: 521


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2658-7947 (Print)
ISSN 2686-7192 (Online)