Gregorios J B, Roldan E, Davis J, Curless R
Department of Pathology, University of Miami--Jackson Memorial Hospital, FL.
J Child Neurol. 1987 Oct;2(4):293-7. doi: 10.1177/088307388700200411.
A case of an encephalomyelitis in a child with acute lymphoblastic leukemia is reported. The patient was a 5-year-old boy who developed seizures, progressive confusion, and coma after radiation and intrathecal methotrexate therapy. Computed tomography (CT) of the brain showed bilateral hypodensities in the posterior parietal and temporal regions. At autopsy, perivascular inflammation, microglial nodules without intranuclear viral inclusions, and bilateral necrosis of the temporoparietal and hippocampal regions were seen in the brain and spinal cord. Paraneoplastic encephalomyelitis is generally recognized in adult patients with underlying malignancy but, to our knowledge, has not been reported in children with leukemia. This report should alert the clinicians to an entity that must be included in the differential diagnosis of leukemic children with progressive neurologic disorder.
报告了一例急性淋巴细胞白血病患儿发生脑脊髓炎的病例。该患者为一名5岁男孩，在接受放疗和鞘内注射甲氨蝶呤治疗后出现癫痫发作、进行性意识模糊和昏迷。脑部计算机断层扫描（CT）显示双侧顶叶后部和颞叶低密度影。尸检时，在脑和脊髓中可见血管周围炎症、无微核病毒包涵体的小胶质结节以及颞顶叶和海马区双侧坏死。副肿瘤性脑脊髓炎通常在患有潜在恶性肿瘤的成年患者中被认识到，但据我们所知，尚未在白血病患儿中报道过。本报告应提醒临床医生注意这一实体，它必须纳入患有进行性神经系统疾病的白血病患儿的鉴别诊断中。
