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High-Dose Methotrexate-Induced Idiopathic Intracranial Hypertension in Infant Acute Lymphoblastic Leukemia
Yazhi Zhang1, Yining Qiu1, Zhujun Wang1
1Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
High-dose methotrexate chemotherapy can cause idiopathic intracranial hypertension in infants with acute lymphoblastic leukemia. Prophylactic dexamethasone effectively prevented these neurological side effects in a reported case.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Pharmacology
Background:
- High-dose methotrexate (HD-MTX) is a critical chemotherapy agent for acute lymphoblastic leukemia (ALL).
- Neurological side effects, including idiopathic intracranial hypertension (IIH), can occur following HD-MTX administration.
- IIH in infants presents unique diagnostic and management challenges.
Abstract:
A 7-month-old baby girl with acute lymphoblastic leukemia (ALL) presented with bulging anterior fontanelle after completing the first and second courses of high-dose methotrexate (HD-MTX) chemotherapy. Between courses, the infant recovered and was discharged. Prior to the third and fourth HD-MTX courses, the baby girl was administered infusions of dexamethasone, which prevented recurrence of neurological side effects observed after the first and second courses of HD-MTX. To our knowledge, this is the first reported case of HD-MTX-induced idiopathic intracranial hypertension in infants, and that prophylactic use of dexamethasone can be applied to prevent acute intracranial hypertension following HD-MTX infusion.
