Conventional and diffusion-weighted MRI findings of methotrexate related sub-acute neurotoxicity.
We describe longitudinal diffusion-weighted MRI findings of sub-acute leukoencephalopathy following methotrexate therapy in a 24-year-old man diagnosed with pre-B-cell acute lymphoblastic leukemia (ALL), presenting with right-sided paralysis and aphasia after second consolidation with intrathecal triple-drug therapy given intrathecally. This case demonstrates the value of DWI in evaluation and diagnosis of sub-acute toxic leukoencephalopathy in patients being treated with methotrexate. The longitudinal follow up DWI findings suggest reversible metabolic derangement rather than ischemia as the cause of these findings.
Balin
Jefferson
J
Department of Radiology, Division of Neuroradiology, United States.
Parmar
Hemant
H
Kujawski
Lisa
L
D000328:Adult; D001927:Brain Diseases / Q000150:complications / Q000188:drug therapy; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*; D020258:Neurotoxicity Syndromes / Q000175:diagnosis* / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy
D007166:Immunosuppressive Agents; D008727:Methotrexate