Liu Hao-Chuan, Hung Giun-Yi, Yen Hsiu-Ju, Hsieh Ming-Yun, Chiou Tzeon-Jye
Department of Pediatrics, Taipei Veterans General Hospital, Taiwan National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
Int J Hematol. 2007 Aug;86(2):163-5. doi: 10.1532/IJH97.A10703.
A 10-year-old boy who had been treated for acute lymphoblastic leukemia presented with persistent numbness of the left big toe and progressive pain of the ipsilateral lower leg. He had received allogeneic bone marrow transplantation 3 months after a testicular relapse. He was in hematologic remission at admission but as progressive swelling of his left leg continued, bone marrow relapse developed. A muscle biopsy revealed leukemic infiltrates in the surrounding muscles of the left sciatic nerve, and swelling of the nerve was found on a magnetic resonance imaging scan. His symptoms/signs subsided soon after reinduction chemotherapy. Unfortunately, he didn't survive because of a fungal sepsis that developed during the neutropenic state. This case represents a rare neurologic complication of what is currently an uncommon presentation for relapse of acute lymphoblastic leukemia, with acute sciatica and without coexisting epidural or leptomeningeal leukemia.
一名曾接受急性淋巴细胞白血病治疗的10岁男孩，出现左大脚趾持续麻木和同侧小腿进行性疼痛。他在睾丸复发3个月后接受了异基因骨髓移植。入院时他处于血液学缓解期，但随着左腿持续进行性肿胀，出现了骨髓复发。肌肉活检显示左侧坐骨神经周围肌肉有白血病浸润，磁共振成像扫描发现神经肿胀。再次诱导化疗后他的症状/体征很快消退。不幸的是，他因中性粒细胞减少状态期间发生的真菌败血症而未能存活。该病例代表了急性淋巴细胞白血病复发目前不常见表现的一种罕见神经并发症，表现为急性坐骨神经痛且无并存的硬膜外或软脑膜白血病。
