A Case of Transfusion-ineffective Epidural and Subdural Hematoma Associated with Meningeal Infiltration of Acute Leukemia Successfully Treated with Kamikihito
- VernacularTitle:急性白血病の髄膜浸潤に随伴し，血小板輸血が無効の硬膜外・硬膜下血腫の改善に加味帰脾湯が寄与した1例
- Author:
Masanori TSUJI
1
Author Information
- Keywords: kamikihito; intracranial hematoma; leukemia; meningeal infiltration; platelet transfusion
- From:Kampo Medicine 2024;75(3):217-224
- CountryJapan
- Language:Japanese
- Abstract: I herein report a case of epidural and subdural hematoma associated with meningeal infiltration of acute leukemia, which was ineffective to platelet transfusion, successfully treated with kamikihito. A 44-year-old woman with mixed phenotype acute leukemia developed left-side facial palsy during bone marrow suppression phase of chemotherapy at first relapse, and was diagnosed as meningeal infiltration. Brain magnetic resonance imaging showed meningeal thickening and epidural and subdural hematoma. The laboratory data showed thrombocytopenia and no remarkable abnormalities in coagulation. She received frequent platelet transfusions, whole-brain irradiation, and intrathecal chemotherapy, with the exacerbation of intracranial hematoma, and whole-brain irradiation and intrathecal chemotherapy had to be discontinued. Intracranial hematoma was improved with additional Kampo therapy with kamikihito in accordance with traditional “sho” indications for the purpose of hemostasis, and restarted intrathecal chemotherapy improved her meningeal infiltration. Finally, she could receive cord blood transplantation because of good control of meningeal infiltration of leukemia and intracranial hematoma. Kampo therapy can be considered one of the treatments for transfusion-ineffective intracranial hematoma.
