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February 1983

Recovery From Probable Central Pontine Myelinolysis Associated With Addison's Disease

Author Affiliations

From the Department of Neurology (Division of Pediatrics), Johns Hopkins University School of Medicine (Drs Kandt and Moser); John F. Kennedy Institute (Dr Moser); and the Department of Pediatrics, St Agnes Hospital (Dr Heldrich), Baltimore. Dr Kandt is now with the University of Michigan, Ann Arbor.

Arch Neurol. 1983;40(2):118-119. doi:10.1001/archneur.1983.04050020080020

Central pontine myelinolysis (CPM), a frequently fatal disorder, is often associated with hyponatremia.1-3 To our knowledge, the first reported case of concurrent CPM and Addison's disease is described herein. The clinical dilemma of proper treatment of severe hyponatremia is exemplified by this case.

REPORT OF A CASE  A 17-year-old girl had amenorrhea 11/2 years before her admission to St Agnes Hospital, Baltimore, on Nov 16, 1980, because of a three-week history of progressive weakness, abdominal pain, anorexia, vomiting, hypotension (BP, 86/56 mm Hg), and severe electrolyte imbalance (serum sodium level, 100 mEq/L; potassium level, 6.6 mEq/L; chloride level, 68 mEq/L; carbon dioxide level, 20 mEq/L; serum urea nitrogen level, 16 mEq/L; glucose level, 78 mEq/L). She had dry skin, dry mucous membranes, and sunken eyes. Her skin was deeply tanned and she was sexually mature. Other than general weakness, results of a neurological examination were normal. Initial treatment