Marchiafava-Bignami disease with haemophagocytic lymphohistiocytosis as a postoperative complication of cardiac surgery. Issue 8 (26th August 2019)

• Record Type: Journal Article
• Authors: Takei, Kentarou; Motoyoshi, Naotaka; Sakamoto, Kazuhiro; Kitamoto, Tetsuyuki
• Is Part Of: BMJ case reports. Volume 12:Issue 8(2019)
• Publication Date: 2019-08-26
• Subjects: neurology -- cardiothoracic surgery; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-230368
• Languages: English
• ISSNs: 1757-790X

Abstract

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.