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Marchiafava-Bignami disease with haemophagocytic lymphohistiocytosis as a postoperative complication of cardiac surgery.
- Source :
-
BMJ case reports [BMJ Case Rep] 2019 Aug 26; Vol. 12 (8). Date of Electronic Publication: 2019 Aug 26. - Publication Year :
- 2019
-
Abstract
- Marchiafava-Bignami disease (MBD) is a rare complication of chronic alcoholism; however, MBD in a non-alcoholic diabetic patient has rarely been reported. The aetiology or pathophysiology of MBD is still unknown. A 50-year-old man with a history of untreated diabetes mellitus underwent on-pump beating coronary artery bypass graft surgery (CABG) surgery for three-vessel and left main coronary disease. 3 days after the surgery, he developed a fever over 40°C and entered a coma state. MRI revealed multiple lesions, including in the corpus callosum, globus pallidus, brain stem and upper cervical spinal cord, which suggested MBD. The patient did not respond to thiamine therapy, but partly responded to steroid therapy. He ultimately died of respiratory failure. The autopsy revealed MBD and haemophagocytic lymphohistiocytosis. It is rare, but systemic inflammatory response syndrome induced by on-pump beating CABG could develop these complication.<br />Competing Interests: Competing interests: None declared.<br /> (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Autopsy methods
Brain diagnostic imaging
Coronary Artery Bypass, Off-Pump methods
Coronary Artery Disease surgery
Fatal Outcome
Humans
Magnetic Resonance Imaging methods
Male
Middle Aged
Coronary Artery Bypass, Off-Pump adverse effects
Corpus Callosum diagnostic imaging
Lymphohistiocytosis, Hemophagocytic etiology
Lymphohistiocytosis, Hemophagocytic pathology
Marchiafava-Bignami Disease diagnosis
Marchiafava-Bignami Disease etiology
Marchiafava-Bignami Disease physiopathology
Postoperative Complications diagnosis
Postoperative Complications physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1757-790X
- Volume :
- 12
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- BMJ case reports
- Publication Type :
- Academic Journal
- Accession number :
- 31451466
- Full Text :
- https://doi.org/10.1136/bcr-2019-230368