Extensive intracranial haemorrhage as a complication of acute lymphoblastic leukaemia with hyperleukocytosis.

Autor: Lim WK; Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia., Fong CY; Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia. Electronic address: cyfong@ummc.edu.my., Li L; Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia., Foo JC; Division of Paediatric Haematology-Oncology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia., Yap TY; Division of Paediatric Haematology-Oncology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
Jazyk: angličtina
Zdroj: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2019 Jun; Vol. 64, pp. 11-14. Date of Electronic Publication: 2019 Apr 02.
DOI: 10.1016/j.jocn.2019.03.056
Abstrakt: We report a rare case of distinctive extensive punctate intracranial haemorrhage associated with acute lymphoblastic leukaemia with hyperleukocytosis. A 7-year-old girl presented with hyperleukocytosis (white cell count 788.7 × 10 9 /L; 94% peripheral blasts) and laboratory tumour lysis syndrome. The diagnosis of T-cell acute lymphoblastic leukaemia was established and confirmed by immunophenotyping of peripheral blood and chemotherapy was commenced promptly. On day 3 of treatment, she developed progressive encephalopathy, left sided hemiparesis with left 6th and upper motor neuron 7th cranial nerve palsy. Brain MRI scan showed extensive punctate haemorrhages with perilesional oedema over the frontal, parietal, occipital, temporal, brainstem and cerebellar regions. The lesions were predominantly over the juxtacortical grey matter. She made a full neurological recovery after 3 months. Our report widens the neuroradiological features of intracranial haemorrhage associated with hyperleukocytosis and highlights the importance of prompt chemotherapy in these patients.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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