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Marked improvement of delayed methotrexate‐induced leukoencephalopathy treated with high‐dose folinic acid
Author(s) -
Hasegawa T.,
Abe K.,
Sakuma R.,
Itoyama Y.
Publication year - 1997
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.1997.tb00395.x
Subject(s) - folinic acid , medicine , leukoencephalopathy , methotrexate , vomiting , white matter , nausea , gastroenterology , chemotherapy , anesthesia , magnetic resonance imaging , radiology , fluorouracil
We report the case of a patient with delayed methotrexate (MTX)‐induced leukoencephalopathy who showed a marked improvement both in clinical and neuroimaging findings after a high‐dose of the active form of folinic acid (leucovorin) treatment. The patient developed progressive affective impairment accompanied by headache, nausea and vomiting after treatment with MTX during the chemotherapy for acute lymphoblastic leukemia, and diagnosed as delayed type MTX‐induced leukoencephalopathy. After an intravenous injection of high‐dose folinic acid (total 1920 mg), neurological deficits and white matter changes dramatically improved in a few weeks. Although delayed MTX‐induced leukoencephalopathy may cause irreversible brain damage, an early treatment with high dose leucovorin may thus facilitate the marked improvement of clinical findings and white matter abnormalities.