Artículos de revistas
Spinal subacute combined degeneration after intrathecal chemotherapy. Report of two cases Síndrome de degeneración combinada de la médula espinal y radiculopatía en dos pacientes por quimioterapia intratecal con metrotrexato y citarabina. Casos clínicos
Fecha
2018Registro en:
Revista Medica de Chile, Volumen 146, Issue 6, 2018, Pages 802-807
07176163
00349887
10.4067/s0034-98872018000600802
Autor
Cartier Rovirosa, Luis
Parra V., Jorge
Puga, Bárbara
Cardemil, Daniela
Institución
Resumen
© 2018, Sociedad Medica de Santiago. All rights reserved.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. T