Intrathecal methotrexate induced myelopathy, rare yet serious complication: A case report and review of the literature
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Elsevier Masson s.r.l.
Abstract
The regular administration of intrathecal chemotherapy has significantly reduced the risk of central nervous system leukemia in patients with acute lymphoblastic leukemia. We report the case of 28-year-old man who developed intrathecal methotrexate induced myelopathy; a rare but serious side effect of intrathecal chemotherapy. In the light of absent effective treatment strategies, description of the case, along with reviewing similar cases published in the literature will help shed a light on the possible pathophysiologic mechanisms behind this injury. To this date, there are no specific clinical, biochemical and imaging signs that would allow timely detection of intrathecal methotrexate induced myelopathy. This in turn is causing delayed treatment of this injury, resulting in significant morbidity and mortality. © 2021 Elsevier Masson SAS
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Acute lymphoblastic leukemia, Intrathecal, Methotrexate, Myelopathy, Adult, Humans, Male, Precursor cell lymphoblastic leukemia-lymphoma, Spinal cord diseases, Cyanocobalamin, Folinic acid, Gabapentin, Methylprednisolone, Article, Bacteremia, Bone marrow, Cancer regression, Case report, Cerebrospinal fluid examination, Clinical article, Dermatome, Drug overdose, Electromyography, Folic acid blood level, Human, Lumbar puncture, Motoneuron, Neurologic examination, Nuclear magnetic resonance imaging, Paraplegia, Physiotherapy, Pneumonia, Polymerase chain reaction, Septic shock, Skin tingling, Spinal cord disease, Thrombocytopenia, Urine retention, Weakness