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Intrathecal Methotrexate-Induced Aseptic Meningitis in a Patient with Acute Lymphoblastic Leukemia
1Department of Medicine, Kettering Medical Center, Kettering, Ohio, USA.
International Journal of Applied & Basic Medical Research
|September 22, 2022
Summary
Intrathecal methotrexate chemotherapy for acute lymphoblastic leukemia (ALL) can rarely cause meningitis-like symptoms, not just stroke-like symptoms. This case highlights a novel neurological complication of ALL treatment.
Area of Science:
- Neurology
- Oncology
- Pharmacology
Background:
- Acute lymphoblastic leukemia (ALL) frequently involves the central nervous system.
- Intrathecal chemotherapy, commonly methotrexate and cytarabine, is standard for CNS ALL.
- Neurological complications, such as stroke-like symptoms, are rare but known side effects of intrathecal methotrexate.
Observation:
- A patient undergoing intrathecal methotrexate chemotherapy for ALL presented with symptoms mimicking bacterial meningitis.
- The patient's clinical presentation differed from the typical stroke-like symptoms previously associated with this treatment.
Findings:
- This case represents the first reported instance of meningitis-like neurological symptoms attributed to intrathecal methotrexate.
- The findings suggest a broader spectrum of potential neurological adverse events from this chemotherapy regimen.
Implications:
- Clinicians should consider meningitis-like symptoms as a potential, albeit rare, adverse effect of intrathecal methotrexate in ALL patients.
- Further investigation may be warranted to understand the mechanism behind this distinct neurological presentation.
- This underscores the importance of vigilant neurological monitoring during chemotherapy for CNS malignancies.
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