Irreversible Paraplegia Following One Time Prophylactic Intrathecal Chemotherapy in an Adult Patient with Acute Lymphoblastic Leukemia.
10.3349/ymj.2008.49.1.151
- Author:
Hea Yong LEE
1
;
Sung il IM
;
Myoung Hee KANG
;
Kwang Min KIM
;
Seok Hyun KIM
;
Hun Gu KIM
;
Jung Hun KANG
;
Gyeong Won LEE
Author Information
1. Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, Gyeong-Sang National University, Jinju, Korea. brightree@lycos.co.kr
- Publication Type:Case Report
- Keywords:
Acute lymphoblastic leukemia;
cytosine arabinoside;
intrathecal chemotherapy;
methotrexate
- MeSH:
Adult;
Antineoplastic Agents/administration & dosage/*adverse effects/*therapeutic use;
Female;
Humans;
Magnetic Resonance Imaging;
Paraplegia/*chemically induced/*pathology;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy
- From:Yonsei Medical Journal
2008;49(1):151-154
- CountryRepublic of Korea
- Language:English
-
Abstract:
We present an adult female patient who developed irreversible paraplegia and areflexia four days post intrathecal chemotherapy with methotrexate, cytosine arabinoside and hydrocortisone. On magnetic resonance imaging (MRI) of the lumbar spine, diffuse gadolinium enhancement of the anterior spinal nerve roots (ventral roots) was detected. Methylprednisolone was intravenously administered at a daily dose of 30mg/kg for three days. Despite this treatment, flaccid weakness in the lower extremities and urinary retention persisted. Following consolidation chemotherapy, no improvement in neurologic status was noted. Six months later, a follow-up MRI revealed severe atrophy of the thoracic spinal cord.
