Clinical Cancer Investigation Journal

CASE REPORT
Year
: 2013  |  Volume : 2  |  Issue : 2  |  Page : 160--162

Delayed reversible methotrexate-induced leucoencephalopathy in a four-year-old child with acute lymphoblastic leukemia


Amrita Roy1, Neelakshi Ghosh1, Aramita Saha2, Somenath Chatterjee3 
1 Department of Paediatric Medicine, Medical College and Hospital, Kolkata, India
2 Department of Radiation Oncology, Medical College and Hospital, Kolkata, India
3 Department of Neuroradiodiagnosis, Apollo Gleneagles Hospitals, Kolkata, India

Correspondence Address:
Amrita Roy
3B, Shyam Square East, Kolkata - 700 003, West Bengal
India

Intravenous/intrathecal methotrexate (MTX) has been implicated as a major cause of treatment-related neurotoxicity particularly leukoencephalopathy in children with hematological malignancy. We report a 4-year-old boy who presented with apathy and aphasia for 1 day while on the maintenance-phase chemotherapy according to MCP 841 protocol. MRI of brain revealed bilateral symmetrical FLAIR hyperintensities in caudate and putaminal region with FLAIR hypersignal in subcortical U-fiber in left frontal lobe consistent with MTX-induced toxic leucoencephalopathy. There was spontaneous resolution of symptoms within 1 week of onset. So, in Pre-B acute lymphoblastic leukemia patients with subtle neurological deficit, this diagnosis should be kept in mind and further treatment with MTX should be carefully decided.


How to cite this article:
Roy A, Ghosh N, Saha A, Chatterjee S. Delayed reversible methotrexate-induced leucoencephalopathy in a four-year-old child with acute lymphoblastic leukemia.Clin Cancer Investig J 2013;2:160-162


How to cite this URL:
Roy A, Ghosh N, Saha A, Chatterjee S. Delayed reversible methotrexate-induced leucoencephalopathy in a four-year-old child with acute lymphoblastic leukemia. Clin Cancer Investig J [serial online] 2013 [cited 2019 Sep 15 ];2:160-162
Available from: http://www.ccij-online.org/article.asp?issn=2278-0513;year=2013;volume=2;issue=2;spage=160;epage=162;aulast=Roy;type=0