A woman with multiple sclerosis and pink saliva

Martha T. Van De Beek, Walter Taal, Rolf F. Veldkamp, Charles J. Vecht*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)


A 25-year-old woman with multiple sclerosis (MS) presented with acute dyspnoea and produced pink saliva. Over the last 9 years she had had transient episodes of neurological symptoms, including pyramidal and cerebellar signs, with periventricular lesions on MRI, high IgG index, and oligoclonal bands in CSF. On admission she was in clear respiratory distress, at which point the her blood pressure was 180/120 mm Hg, heart rate was 92 beats/min, and pulse oxygen was 95%. Heart sounds were normal, and basal crackles were present predominantly over the left lung. The initial neurological examination was normal. The electrocardiogram was normal. Chest radiography showed a heart of normal size and diffuse interstitial pulmonary oedema, mostly left sided. We also did a CT scan of the brain, chest, and abdomen that showed no abnormalities apart from pulmonary oedema. Blood-gas analysis showed metabolic acidosis (pH was 7·27; PO2 was 86 mm Hg; PCO2 was 38·4 mm Hg; HCO3 was 17·4 mmol/L; lactate was 5·2 mol/L [0·5–2·2]).
Original languageEnglish
Pages (from-to)254-255
Number of pages2
JournalLancet Neurology
Issue number4
Publication statusPublished - 1 Apr 2003
Externally publishedYes


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