Pseudotumour Cerebri Following High‐dose Cytosine Arabinoside

Evers, Joseph P.; Jacobson, Robert J.; Pincus, Jonathan H.; Zwiebel, James A.

doi:10.1111/j.1365-2141.1992.tb04575.x

Cited by 15 publications

(5 citation statements)

References 4 publications

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“…There were two reports of cytarabine as a possible etiology. Evers et al [12] reported benign intracranial hypertension following high-dose cytosine arabinoside. Fort and Smith [13] reported benign intracranial hypertension secondary to intermediate dose of cytarabine hydrochloride.…”

Section: Discussionmentioning

confidence: 98%

Benign Intracranial Hypertension in Association with Acute Lymphoblastic Leukemia

Sastry¹,

Karandikar²,

English³

2003

Pediatric Hematology and Oncology

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Benign intracranial hypertension, also known as pseudotumor cerebri, is a headache syndrome characterized by (1) raised cerebrospinal fluid (CSF) pressure in the absence of an intracranial mass lesion or ventricular dilatation; (2) normal spinal fluid composition; (3) usually normal findings on neurological examination, except for papilloedema and an occasional VI nerve palsy; and (4) normal level of consciousness [1]. It is an uncommon condition in childhood, presenting once or twice a year in a large referral hospital. Although described as benign, the condition can disrupt normal life and cause significant visual failure. Early recognition and management may help alleviate symptoms and preserve vision. We report a case of 14-year-old boy with T-cell acute lymphoblastic leukemia who developed pseudotumor cerebri during the consolidation phase of treatment. CASE REPORTOur patient was a 14-year-old boy first seen in December 2000 with a history of generalized lymphadenopathy and weight loss. Examination revealed significant cervical lymphadenopathy and pallor. Full blood count at diagnosis revealed hemoglobin of 13.1 g/L, white cell count of 19 × 10 9 /L, and a platelet count of 85 × 10 9 /L. Peripheral blood smear revealed blast cells, and bone marrow examination confirmed the diagnosis of acute lymphoblastic leukemia and immunophenotyping confirmed it to be T-cell leukemia. All parts of his coagulation profile, including a prothrombin time, activated partial thromboplastin time, thrombin time, and serum fibrinogen, were all within normal limits. He was commenced on chemotherapy according to Regimen B of MRC ALL 97/99 protocol. He tolerated the initial induction chemotherapy (weeks 1-4) well. This included prednisolone (40 mg/m 2 ) for

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Section: Discussionmentioning

confidence: 98%

Benign Intracranial Hypertension in Association with Acute Lymphoblastic Leukemia

Sastry¹,

Karandikar²,

English³

2003

Pediatric Hematology and Oncology

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“…In fact, countless factors may cause pediatric ICH including drugs (tetracycline, cytarabine, corticosteroid withdrawal….). IIH following HiDAC is well-known to be rare [ 12 ]. It highlights the linear association between CSF concentrations and plasma levels of cytosine arabinoside [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…In our case, the patient is a child and as we mentioned previously that during pre- puberty, IIH affects boys and girls equally [ 4 , 9 ]. For HiDAC associated IIH, few cases have been published and there no gender difference has been reported [ 12 , 21 ]. For both etiologies, the most predominant symptom for IIH is headache and other neurological signs can appear over the time [ 9 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

The diagnostic dilemma of idiopathic intracranial hypertension in a child with acute lymphoblastic leukemia: COVID-19 or cytosine arabinoside?

et al. 2022

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Background Idiopathic intracranial hypertension is a rare neurological condition among children. Its manifestations vary from mild headaches to loss of vision. Although rare, COVID-19 infection and high dose cytosine arabinoside have been reported as risk factors for this neurological disorder. In patients with acute leukemia, idiopathic intracranial hypertension diagnosis is simple, but finding its etiology can be difficult. Case presentation We report a case of a 9-year-old boy with an ongoing treatment for T-acute lymphoblastic leukemia presenting with persistent headaches and diplopia. A diagnosis of idiopathic intracranial hypertension was retained based on clinical, imaging and laboratory findings. Due to its rarity, we describe its clinical and therapeutic features and highlight the challenging etiological dilemma between COVID-19 infection and high dose cytosine arabinoside administration. Conclusion Persistent headache in a pediatric patient with leukemia can be due to many neurological disorders other than leukemic relapse. Given the improvement of the neurological symptoms after the SARS-CoV-2 PCR negativization and the successful re-introduction of high dose cytosine Arabinoside, the diagnosis of idiopathic intracranial hypertension associated with Covid-19 infection was withheld.

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“…6,7 Cytarabine may deplete phosphorus stores and disturb the ATPase-dependent choroidal secretion of CSF. 14 Neurologic toxicity with cytarabine has been widely recognized. Serious manifestations are cerebellar syndrome, peripheral neuropathy, somnolence, confusion, and seizures.…”

Section: Discussionmentioning

confidence: 99%

“…A 29-year-old woman with acute promyelocytic leukemia developed IIH after her fourth course of chemotherapy. 14 After induction with Ara-C 100 mg/m 2 /d for seven days and three days of daunomycin 45 mg/m 2 /d, she received Ara-C 3 g/m 2 every 12 hours for 12 doses, followed by a second course of seven days of Ara-C 100 mg/m 2 with daunomycin 45 mg/m 2 /d. Ten days after starting her second course of high-dose Ara-C, the patient developed fever, nausea, and vomiting.…”

Section: Discussionmentioning

confidence: 99%