1. Methotrexate-induced transient encephalopathy in an adolescent and young adult patient with acute lymphoblastic leukemia
- Author
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Masaaki Kume, Satoshi Takahashi, Rui Kondo, Kazuaki Teshima, Hiroaki Aono, Satsuki Takahashi, Ko Abe, Naoto Takahashi, S Fushimi, Masahiro Saito, and Kenichi Shibata
- Subjects
Adolescent ,Encephalopathy ,Case Report ,acute lymphoblastic leukemia ,transient encephalopathy ,030204 cardiovascular system & hematology ,methotrexate ,Magnetic resonance angiography ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Centrum semiovale ,Internal Medicine ,Edaravone ,Humans ,Medicine ,vasospasm ,Brain Diseases ,medicine.diagnostic_test ,adolescent and young adult ,business.industry ,Magnetic resonance imaging ,Vasospasm ,General Medicine ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Paresis ,Diffusion Magnetic Resonance Imaging ,Hemiparesis ,chemistry ,Anesthesia ,Female ,030211 gastroenterology & hepatology ,Methotrexate ,medicine.symptom ,business ,medicine.drug - Abstract
A 17-year-old girl was diagnosed with acute lymphoblastic leukemia (ALL). After the administration of high-dose methotrexate (MTX) or intrathecal MTX, the patient experienced transient hemiparesis and motor aphasia. Diffusion-weighted magnetic resonance imaging showed a high-intensity lesion in the bilateral centrum semiovale, and a vasospasm was detected in the proximal segment of bilateral A1 on magnetic resonance angiography. Edaravone was administered, and leucovorin rescue treatment was continued; eventually, the patient's neurological symptoms completely resolved. This finding suggested that vasospasm might be a mechanism underlying MTX-induced transient encephalopathy in adolescent and young adult patients with ALL.
- Published
- 2021
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