High-Dose Methotrexate-Induced Idiopathic Intracranial Hypertension in Infant Acute Lymphoblastic Leukemia

Yazhi Zhang; Yining Qiu; Zhujun Wang; Ran Wang; Runming Jin; Louis Edward Hinkle; Xiaoyan Wu

doi:10.3389/fphar.2020.00839

High-Dose Methotrexate-Induced Idiopathic Intracranial Hypertension in Infant Acute Lymphoblastic Leukemia

Front Pharmacol. 2020 Jun 17:11:839. doi: 10.3389/fphar.2020.00839. eCollection 2020.

Authors

Yazhi Zhang¹, Yining Qiu¹, Zhujun Wang¹, Ran Wang¹, Runming Jin¹, Louis Edward Hinkle², Xiaoyan Wu¹

Affiliations

¹ Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, United States.

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.

Keywords: acute lymphoblastic leukemia; dexamethasone; high-dose methotrexate; idiopathic intracranial hypertension; neurotoxicity.

Publication types

Case Reports