PMID- 34277193
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210720
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 13
IP  - 6
DP  - 2021 Jun
TI  - Unusual Neurological Manifestation of Proton Pump Inhibitor: A Case Report of 
      Acute Disseminated Encephalomyelitis and Severe Hyponatremia After Brief Use of 
      Proton Pump Inhibitor.
PG  - e15571
LID - 10.7759/cureus.15571 [doi]
LID - e15571
AB  - Hyponatremia is commonly reported after the use of proton pump inhibitors (PPI). 
      While omeprazole is most likely to cause hyponatremia, almost all the PPIs have 
      been reported to cause hyponatremia. The underlying mechanism of PPI-induced 
      hyponatremia is a syndrome of inappropriate antidiuretic hormone (SIADH) 
      secretion which leads to hyponatremia. The hyponatremia can develop with only a 
      few days of exposure to PPI. We present a case of a 56-year-old previously 
      healthy female who was prescribed omeprazole for trivial acid reflux symptoms 
      when she presented to the emergency room for evaluation of generalized weakness. 
      She was discharged home from the emergency room after clinical evaluation as she 
      had essentially normal lab work including a negative COVID PCR test. She 
      subsequently developed progressive weakness of extremities and slurred speech 
      over the next three days. She returned back to the emergency room and was found 
      to have profound hyponatremia with MRI evidence of acute disseminated 
      encephalomyelitis (ADEM). She was treated with hypertonic saline to correct 
      hyponatremia and omeprazole was discontinued. The patient also received pulse 
      dose steroids with improvement in her symptoms.
CI  - Copyright (c) 2021, Qureshi et al.
FAU - Qureshi, Ahmad S
AU  - Qureshi AS
AD  - Critical Care Medicine, National Guard Health Affairs, Al Madinah, SAU.
FAU - Quadri, Mohammad A
AU  - Quadri MA
AD  - Critical Care Medicine, National Guard Health Affairs, Al Madinah, SAU.
FAU - Javed, Babar
AU  - Javed B
AD  - Critical Care Medicine, National Guard Health Affairs, Al Madinah, SAU.
LA  - eng
PT  - Case Reports
DEP - 20210610
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC8272598
OTO - NOTNLM
OT  - acute disseminated encephalomyelitis
OT  - female
OT  - hyponatremia
OT  - mri
OT  - omeprazole
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/07/20 06:00
MHDA- 2021/07/20 06:01
PMCR- 2021/06/10
CRDT- 2021/07/19 05:57
PHST- 2021/06/10 00:00 [accepted]
PHST- 2021/07/19 05:57 [entrez]
PHST- 2021/07/20 06:00 [pubmed]
PHST- 2021/07/20 06:01 [medline]
PHST- 2021/06/10 00:00 [pmc-release]
AID - 10.7759/cureus.15571 [doi]
PST - epublish
SO  - Cureus. 2021 Jun 10;13(6):e15571. doi: 10.7759/cureus.15571. eCollection 2021 
      Jun.