Methotrexate-induced Leukoencephalopathy without Typical Restricted Diffusion on Diffusion-weighted Imaging and the Utility of Magnetic Resonance Spectroscopy to Support the Diagnosis

Methotrexate (MTX) is a common antimetabolite agent that is widely used today in treating leukemia, lymphoma, and osteosarcoma. Its use has been associated with leukoencephalopathy causing seizures, paralysis, and even coma. To achieve the best possible outcome, it is important to be able to make a...

Descripción completa

Detalles Bibliográficos
Autores principales: Doan, Ninh, Patel, Mohit, Nguyen, Ha Son, Doan, Hayley, Shabani, Saman, Gelsomino, Michael, Mountoure, Andrew, Janich, Karl, Chitambar, Christopher R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159078/
https://www.ncbi.nlm.nih.gov/pubmed/30283563
http://dx.doi.org/10.4103/ajns.AJNS_324_16
_version_ 1783358554031259648
author Doan, Ninh
Patel, Mohit
Nguyen, Ha Son
Doan, Hayley
Shabani, Saman
Gelsomino, Michael
Mountoure, Andrew
Janich, Karl
Chitambar, Christopher R.
author_facet Doan, Ninh
Patel, Mohit
Nguyen, Ha Son
Doan, Hayley
Shabani, Saman
Gelsomino, Michael
Mountoure, Andrew
Janich, Karl
Chitambar, Christopher R.
author_sort Doan, Ninh
collection PubMed
description Methotrexate (MTX) is a common antimetabolite agent that is widely used today in treating leukemia, lymphoma, and osteosarcoma. Its use has been associated with leukoencephalopathy causing seizures, paralysis, and even coma. To achieve the best possible outcome, it is important to be able to make a prompt diagnosis. Studies reported restricted diffusion on diffusion-weighted imaging (DWI) which is a reliable early sign of acute MTX-induced leukoencephalopathy. However, we report here the first case of MTX-induced leukoencephalopathy without typical restricted diffusion on DWI and the utility magnetic resonance spectroscopy to support this diagnosis in the difficult case such as the one being presented here.
format Online
Article
Text
id pubmed-6159078
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-61590782018-10-03 Methotrexate-induced Leukoencephalopathy without Typical Restricted Diffusion on Diffusion-weighted Imaging and the Utility of Magnetic Resonance Spectroscopy to Support the Diagnosis Doan, Ninh Patel, Mohit Nguyen, Ha Son Doan, Hayley Shabani, Saman Gelsomino, Michael Mountoure, Andrew Janich, Karl Chitambar, Christopher R. Asian J Neurosurg Case Report Methotrexate (MTX) is a common antimetabolite agent that is widely used today in treating leukemia, lymphoma, and osteosarcoma. Its use has been associated with leukoencephalopathy causing seizures, paralysis, and even coma. To achieve the best possible outcome, it is important to be able to make a prompt diagnosis. Studies reported restricted diffusion on diffusion-weighted imaging (DWI) which is a reliable early sign of acute MTX-induced leukoencephalopathy. However, we report here the first case of MTX-induced leukoencephalopathy without typical restricted diffusion on DWI and the utility magnetic resonance spectroscopy to support this diagnosis in the difficult case such as the one being presented here. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6159078/ /pubmed/30283563 http://dx.doi.org/10.4103/ajns.AJNS_324_16 Text en Copyright: © 2018 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Doan, Ninh
Patel, Mohit
Nguyen, Ha Son
Doan, Hayley
Shabani, Saman
Gelsomino, Michael
Mountoure, Andrew
Janich, Karl
Chitambar, Christopher R.
Methotrexate-induced Leukoencephalopathy without Typical Restricted Diffusion on Diffusion-weighted Imaging and the Utility of Magnetic Resonance Spectroscopy to Support the Diagnosis
title Methotrexate-induced Leukoencephalopathy without Typical Restricted Diffusion on Diffusion-weighted Imaging and the Utility of Magnetic Resonance Spectroscopy to Support the Diagnosis
title_full Methotrexate-induced Leukoencephalopathy without Typical Restricted Diffusion on Diffusion-weighted Imaging and the Utility of Magnetic Resonance Spectroscopy to Support the Diagnosis
title_fullStr Methotrexate-induced Leukoencephalopathy without Typical Restricted Diffusion on Diffusion-weighted Imaging and the Utility of Magnetic Resonance Spectroscopy to Support the Diagnosis
title_full_unstemmed Methotrexate-induced Leukoencephalopathy without Typical Restricted Diffusion on Diffusion-weighted Imaging and the Utility of Magnetic Resonance Spectroscopy to Support the Diagnosis
title_short Methotrexate-induced Leukoencephalopathy without Typical Restricted Diffusion on Diffusion-weighted Imaging and the Utility of Magnetic Resonance Spectroscopy to Support the Diagnosis
title_sort methotrexate-induced leukoencephalopathy without typical restricted diffusion on diffusion-weighted imaging and the utility of magnetic resonance spectroscopy to support the diagnosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159078/
https://www.ncbi.nlm.nih.gov/pubmed/30283563
http://dx.doi.org/10.4103/ajns.AJNS_324_16
work_keys_str_mv AT doanninh methotrexateinducedleukoencephalopathywithouttypicalrestricteddiffusionondiffusionweightedimagingandtheutilityofmagneticresonancespectroscopytosupportthediagnosis
AT patelmohit methotrexateinducedleukoencephalopathywithouttypicalrestricteddiffusionondiffusionweightedimagingandtheutilityofmagneticresonancespectroscopytosupportthediagnosis
AT nguyenhason methotrexateinducedleukoencephalopathywithouttypicalrestricteddiffusionondiffusionweightedimagingandtheutilityofmagneticresonancespectroscopytosupportthediagnosis
AT doanhayley methotrexateinducedleukoencephalopathywithouttypicalrestricteddiffusionondiffusionweightedimagingandtheutilityofmagneticresonancespectroscopytosupportthediagnosis
AT shabanisaman methotrexateinducedleukoencephalopathywithouttypicalrestricteddiffusionondiffusionweightedimagingandtheutilityofmagneticresonancespectroscopytosupportthediagnosis
AT gelsominomichael methotrexateinducedleukoencephalopathywithouttypicalrestricteddiffusionondiffusionweightedimagingandtheutilityofmagneticresonancespectroscopytosupportthediagnosis
AT mountoureandrew methotrexateinducedleukoencephalopathywithouttypicalrestricteddiffusionondiffusionweightedimagingandtheutilityofmagneticresonancespectroscopytosupportthediagnosis
AT janichkarl methotrexateinducedleukoencephalopathywithouttypicalrestricteddiffusionondiffusionweightedimagingandtheutilityofmagneticresonancespectroscopytosupportthediagnosis
AT chitambarchristopherr methotrexateinducedleukoencephalopathywithouttypicalrestricteddiffusionondiffusionweightedimagingandtheutilityofmagneticresonancespectroscopytosupportthediagnosis

Ejemplares similares