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KMID : 0311120080490010151
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Yonsei Medical Journal
2008 Volume.49 No. 1 p.151 ~ p.154
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Irreversible Paraplegia Following One Time Prophylactic Intrathecal Chemotherapy in an Adult Patient with Acute Lymphoblastic Leukemia
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Lee Hea-Yong
Lee Gyeong-Won
Kim Kwang-Min
Kang Myoung-Hee
Kang Jung-Hun
lm Sung-il
Kim Seok-Hyun
Kim Hoon-Gu
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Abstract
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We present an adult female patient who developed irreversible paraplegia and areflexia four days post intrathecal
chemotherapy with methotrexate, cytosine arabinoside and hydrocortisone. On magnetic resonance imaging (MRI) of the
lumbar spine, diffuse gadolinium enhancement of the anterior spinal nerve roots (ventral roots) was detected. Methylprednisolone was intravenously administered at a daily dose of 30 mg/kg for three days. Despite this treatment, flaccid weakness in the lower extremities and urinary retention persisted.Following consolidation chemotherapy, no improvement in neurologic status was noted. Six months later, a follow-up MRI revealed severe atrophy of the thoracic spinal cord.
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KEYWORD
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Acute lymphoblastic leukemia, cytosine arabinoside, intrathecal chemotherapy, methotrexate
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