Síndrome de degeneración combinada de la médula espinal y radiculopatía en dos pacientes por quimioterapia intratecal con metrotrexato y citarabina: casos clínicos / Spinal subacute combined degeneration after intrathecal chemotherapy: report of two cases
Rev. méd. Chile
;
146(6): 802-807, jun. 2018. tab, graf
Artículo
en Español
| LILACS
| ID: biblio-961462
ABSTRACT
Intrathecal chemotherapy may be complicated with the development of myelopathies or toxic radiculopathies. This myeloradicular involvement, of toxic character, is unpredictable, since these patients have repeatedly received Intrathecal chemotherapy with the same drugs without apparent injury. The toxic effect should be mainly attributed to Cytarabine and not to methotrexate, since the central nervous system lacks Cytidine deaminase, the enzyme that degrades Cytarabine. We report two patients, an 18-year-old woman and a 16 years old male, who received systemic and intrathecal chemotherapy (methotrexate, cytarabine) for the treatment of an acute lymphoblastic leukemia and developed, in relation to this procedure, a spinal subacute combined degeneration. They had a proprioceptive and motor alteration of the lower extremities and neuroimaging showed selective rear and side spinal cord hyper intensity produced by central axonopathy. Two weeks later the woman developed a quadriplegia and the young man a flaccid paraplegia due to added root involvement.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Metotrexato
/
Citarabina
/
Degeneración Combinada Subaguda
/
Leucemia-Linfoma Linfoblástico de Células Precursoras
/
Antimetabolitos Antineoplásicos
Límite:
Adolescente
/
Femenino
/
Humanos
Idioma:
Español
Revista:
Rev. méd. Chile
Asunto de la revista:
Medicina
Año:
2018
Tipo del documento:
Artículo
País de afiliación:
Chile
Institución/País de afiliación:
Universidad de Chile/CL
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