Kanekura S, Takezaki T, Kawakami K
Department of Pediatrics, Faculty of Medicine, Kagoshima University.
Rinsho Ketsueki. 1992 Sep;33(9):1221-5.
In this report, we described a case of acute lymphoblastic leukemia with leukoencephalopathy that responded to oxygenation under hyperbaric pressure (OHP) therapy. The patient was 6 year-old female who was diagnosed as acute lymphoblastic leukemia (ALL) one year and 9 months earlier. After the first relapse of the central nervous system (CNS) leukemia, intrathecal administration of methotrexate (MTX) and skull irradiation induced CNS remission. The patient was readmitted because of second CNS relapse. After the third administration of weekly intrathecal MTX injection, apathy and finger tremor were observed. Her conscious disturbance continued for two weeks and magnetic resonance imaging (MRI) revealed abnormal findings in the white matter of her brain. Subsequently OHP therapy was commenced, and the conscious disturbance was improved gradually. One month later, neuro-disturbance resolved completely and the findings of MRI were improved. We could not find any case of leukoencephalopathy which was treated with OHP in the literature. But our case suggested that OHP therapy is valuable in patient with leukoencephalopathy in the early stage.
在本报告中,我们描述了一例急性淋巴细胞白血病合并白质脑病的病例,该病例对高压氧治疗(OHP)有反应。患者为一名6岁女性,一年零九个月前被诊断为急性淋巴细胞白血病(ALL)。中枢神经系统(CNS)白血病首次复发后,鞘内注射甲氨蝶呤(MTX)和头颅照射诱导了CNS缓解。患者因CNS再次复发而再次入院。在每周第三次鞘内注射MTX后,观察到患者出现冷漠和手指震颤。她的意识障碍持续了两周,磁共振成像(MRI)显示其脑白质有异常表现。随后开始进行OHP治疗,意识障碍逐渐改善。一个月后,神经功能障碍完全消失,MRI检查结果也有所改善。我们在文献中未发现任何用OHP治疗白质脑病的病例。但我们的病例表明,OHP治疗对早期白质脑病患者有价值。