TY - JOUR
T1 - Marchiafava-Bignami disease with haemophagocytic lymphohistiocytosis as a postoperative complication of cardiac surgery
AU - Takei, Kentarou
AU - Motoyoshi, Naotaka
AU - Sakamoto, Kazuhiro
AU - Kitamoto, Tetsuyuki
N1 - Publisher Copyright:
© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - 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.
AB - 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.
KW - cardiothoracic surgery
KW - neurology
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U2 - 10.1136/bcr-2019-230368
DO - 10.1136/bcr-2019-230368
M3 - Article
C2 - 31451466
AN - SCOPUS:85071676289
SN - 1757-790X
VL - 12
JO - BMJ Case Reports
JF - BMJ Case Reports
IS - 8
M1 - e230368
ER -