Pseudotumor cerebri secondary to intermediate-dose cytarabine HCl
Objective:
To describe a case of pseudotumor cerebri associated with the administration of intermediate-dose cytarabine.
Case Summary:
An 11-year-old Hispanic boy with acute myeloblastic leukemia developed symptoms of pseudotumor cerebri (headache, diplopia, photophobia, nausea, vomiting) after receiving chemotherapy including cytarabine. The patient improved after a lumbar puncture and treatment with prednisone and acetazolamide, and is now asymptomatic.
Discussion:
Pseudotumor cerebri is a condition usually associated with obese women of child-bearing age. Case reports in pediatric patients are unusual. Several medications have been implicated in causing pseudotumor cerebri, including antimicrobials (tetracycline, naladixic acid), amiodarone, lithium carbonate, vitamin A and its derivatives, growth hormone, and corticosteroids. Chemotherapy agents reported to cause pseudotumor cerebri include busulfan with cyclophosphamide, and the combination of vinblastine, cisplatin, and bleomycin. Most of the information on medication-induced pseudotumor cerebri is in the form of case reports. Different mechanisms for causing this condition have been offered for individual medications. Most of these explanations involve fluid imbalance or interference with the Na+/K+ adenosine triphosphatase pump. Controlled studies are difficult because this condition is an unpredictable and rare occurrence. Cytarabine has frequently been associated with neurologic toxicities, but few reports of pseudotumor cerebri can be found.
Conclusions:
The exact cause of pseudotumor cerebri in this patient is unknown, but cytarabine seems a likely cause. The mechanism by which cytarabine could cause this reaction is unclear.
Insights
A rare case of pseudotumor cerebri occurred in a pediatric patient receiving cytarabine chemotherapy. This condition, typically seen in adult women, presented with headaches and vision changes, resolving with treatment.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Pharmacology
Background:
- Pseudotumor cerebri (idiopathic intracranial hypertension) is rarely reported in pediatric cancer patients.
- Medication-induced pseudotumor cerebri is uncommon, with various agents implicated.
- Cytarabine is a common chemotherapy agent with known neurological toxicities, but its link to pseudotumor cerebri is poorly documented.
Observation:
- An 11-year-old boy with acute myeloblastic leukemia developed symptoms of pseudotumor cerebri, including headache, diplopia, photophobia, nausea, and vomiting.
- These symptoms emerged following the administration of intermediate-dose cytarabine chemotherapy.
- The patient's condition improved significantly after lumbar puncture and treatment with prednisone and acetazolamide.
Findings:
- This case highlights a potential association between cytarabine chemotherapy and the development of pseudotumor cerebri in a pediatric patient.
- While the exact mechanism remains unclear, cytarabine is considered a likely causative agent.
- The rarity of this adverse event in children underscores the need for vigilance during chemotherapy.
Implications:
- This report expands the known spectrum of neurological side effects associated with cytarabine.
- Clinicians should consider pseudotumor cerebri in pediatric patients presenting with relevant symptoms during cytarabine treatment.
- Further investigation into the neurotoxic mechanisms of cytarabine may be warranted.
More Related Videos
06:08Assessment of Chimeric Antigen Receptor T Cell-Associated Toxicities Using an Acute Lymphoblastic Leukemia Patient-Derived Xenograft Mouse Model
Published on: February 10, 2023
09:11Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024