Summers Ryan J, Abramowsky Carlos R, Cooper Todd M
Departments of *Pediatrics †Pathology, Emory University School of Medicine ‡Aflac Cancer Center and Blood Disorders Service, Children's Healthcare of Atlanta, Atlanta, GA.
J Pediatr Hematol Oncol. 2014 Jan;36(1):e19-22. doi: 10.1097/MPH.0b013e31827b6adb.
Intrathecal and systemic methotrexate (MTX), as well as cranial radiation, are effective modalities to prevent central nervous system relapse in childhood acute lymphoblastic leukemia. Leukoencephalopathy is a well-described adverse effect of MTX therapy and is associated with a wide range of neurological sequelae. Most recent studies of MTX-induced leukoencephalopathy have focused exclusively on imaging findings, particularly magnetic resonance imaging. Here we report a case of severe MTX-induced leukoencephalopathy with unique magnetic resonance imaging findings and pathologic correlation from a brain biopsy taken during a period of active neurological symptomatology.
鞘内注射和全身应用甲氨蝶呤（MTX）以及颅脑放疗是预防儿童急性淋巴细胞白血病中枢神经系统复发的有效方法。白质脑病是MTX治疗中一种广为人知的不良反应，与多种神经后遗症相关。最近关于MTX诱导的白质脑病的研究仅专注于影像学表现，尤其是磁共振成像。在此，我们报告一例严重的MTX诱导的白质脑病病例，该病例具有独特的磁共振成像表现以及在神经症状活跃期进行脑活检的病理相关性。
