Methotrexate-induced subacute myelopathy: a serious but treatable complication.
J Clin Exp Hematop
; 63(4): 251-256, 2023.
Article
em En
| MEDLINE
| ID: mdl-38148015
ABSTRACT
Subacute myelopathy is a rare but serious complication of methotrexate (MTX) that may cause paraplegia. Although its underlying mechanisms have not been fully elucidated, homocysteine is thought to play a role in the pathogenesis of this adverse effect. Herein, we report the case of a 34-years old female patient with diffuse large B-cell lymphoma who developed progressive paraplegia accompanied by dysfunctional bladder and bowel movements after treatment with a modified CODOX-M/IVAC regimen, including high-dose intravenous MTX and intrathecal (IT-) MTX. Neurological symptoms gradually improved to almost normal levels within 4.5 months of onset following treatment with a combination of S-adenosylmethionine, methionine, cyanocobalamin, and folate. During chemotherapy, including high-dose MTX and IT-MTX for hematological malignancies, MTX-induced subacute neuronal damage should be carefully evaluated, and appropriate treatment should be initiated as early as possible.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças da Medula Espinal
/
Doenças da Medula Óssea
/
Linfoma Difuso de Grandes Células B
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
J Clin Exp Hematop
Assunto da revista:
HEMATOLOGIA
/
PATOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Japão