Reversible tetraplegia after percutaneous nephrostolithotomy and septic shock: a case of critical illness polyneuropathy and myopathy with acute onset and complete recovery

BMC Nephrology

Case Report

Li-Min Wu¹  Hong-Liang Zhang¹  Xiang-Bo Kong²  Yi Hou²  Hong-Yan Li²  Rui Zhao²  Hai Li³ 

[1] Department of Neurology, The First Bethune Hospital of Jilin University, Jilin University, Xinmin Street 71#, 130021, Changchun, China;Department of Urology, The China-Japan Union Hospital of Jilin University, Changchun, China;Department of Urology, The China-Japan Union Hospital of Jilin University, Changchun, China;Department of Neurology, The First Bethune Hospital of Jilin University, Jilin University, Xinmin Street 71#, 130021, Changchun, China;

关键词: Critical illness polyneuropathy;    Critical illness myopathy;    Percutaneous nephrostolithotomy;    Sepsis;    Guillain-Barré syndrome;   

DOI  :  10.1186/1471-2369-14-36

 received in 2012-03-04, accepted in 2013-02-06,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundCritical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are complications causing weakness of respiratory and limb muscles in critically ill patients. As an important differential diagnosis of Guillain-Barré syndrome (GBS), CIP and CIM should be diagnosed with caution, after a complete clinical and laboratory examination. Although not uncommon in ICU, CIP and CIM as severe complications of percutaneous nephrostolithotomy (PNL) have not been documented in literature.Case presentationA 48-year-old Chinese woman was referred to our hospital, complaining of occasional pain in the right lower back for one month. Lithiasis was diagnosed by ultrasonographical and radiological examinations on the urinary system. PNL was indicated and performed. The patient developed CIP and CIM on the fourth day after PNL. Early recognition and treatment of the severe complications contributed to a satisfactory recovery of the patient.ConclusionThis case expands our understanding of the complications of PNL and underscores the importance of differentiating CIP/CIM from GBS in case of such patients developing weakness after the treatment. Clinical characteristics and examination results should be carefully evaluated to make the diagnosis of CIP or CIM. Both anti-septic prophylaxis and control of hyperglycemia might be effective for the prevention of CIP or CIM; aggressive treatment on sepsis and multiple organ failure is considered to be the most effective measure to reduce the incidence of CIP/CIM.

【 授权许可】

Unknown   
© Li et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.