Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia

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...

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Autores principales: Teshima, Kazuaki, Kume, Masaaki, Kondo, Rui, Shibata, Kenichi, Abe, Ko, Aono, Hiroaki, Fushimi, Susumu, Takahashi, Satoshi, Takahashi, Satsuki, Saito, Masahiro, Takahashi, Naoto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313907/
https://www.ncbi.nlm.nih.gov/pubmed/33518561
http://dx.doi.org/10.2169/internalmedicine.5937-20
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author Teshima, Kazuaki
Kume, Masaaki
Kondo, Rui
Shibata, Kenichi
Abe, Ko
Aono, Hiroaki
Fushimi, Susumu
Takahashi, Satoshi
Takahashi, Satsuki
Saito, Masahiro
Takahashi, Naoto
author_facet Teshima, Kazuaki
Kume, Masaaki
Kondo, Rui
Shibata, Kenichi
Abe, Ko
Aono, Hiroaki
Fushimi, Susumu
Takahashi, Satoshi
Takahashi, Satsuki
Saito, Masahiro
Takahashi, Naoto
author_sort Teshima, Kazuaki
collection PubMed
description 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.
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spelling pubmed-83139072021-08-11 Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia Teshima, Kazuaki Kume, Masaaki Kondo, Rui Shibata, Kenichi Abe, Ko Aono, Hiroaki Fushimi, Susumu Takahashi, Satoshi Takahashi, Satsuki Saito, Masahiro Takahashi, Naoto Intern Med Case Report 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. The Japanese Society of Internal Medicine 2021-02-01 2021-07-01 /pmc/articles/PMC8313907/ /pubmed/33518561 http://dx.doi.org/10.2169/internalmedicine.5937-20 Text en Copyright © 2021 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Teshima, Kazuaki
Kume, Masaaki
Kondo, Rui
Shibata, Kenichi
Abe, Ko
Aono, Hiroaki
Fushimi, Susumu
Takahashi, Satoshi
Takahashi, Satsuki
Saito, Masahiro
Takahashi, Naoto
Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia
title Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia
title_full Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia
title_fullStr Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia
title_full_unstemmed Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia
title_short Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia
title_sort methotrexate-induced transient encephalopathy in an adolescent and young adult patient with acute lymphoblastic leukemia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313907/
https://www.ncbi.nlm.nih.gov/pubmed/33518561
http://dx.doi.org/10.2169/internalmedicine.5937-20
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