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Drug: Methotrexate

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Total 117 results found since Jan 2013.

Evaluation and Management of Acute-Onset Hemiparesis in an Adolescent With Leukemia
We present a case of a 15-year-old boy with pre-B acute lymphoblastic leukemia on chemotherapy, having recently received a high-dose methotrexate infusion in addition to intrathecal methotrexate therapy, who presented to our ED with acute right-sided hemiparesis. He was initially suspected as having a possible ischemic stroke. Magnetic resonance imaging (diffusion-weighted and fluid-attenuated inversion recovery sequence) demonstrated focal areas of diffusion restriction, an early sign of delayed-onset methotrexate neurotoxicity. Our patient received appropriate supportive care and leucovorin rescue with gradual clinical r...
Source: Pediatric Emergency Care - March 1, 2018 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Methotrexate might reduce ischemic stroke in patients with rheumatoid arthritis: a population ‐based retrospective cohort study
International Journal of Rheumatic Diseases, EarlyView.
Source: APLAR Journal of Rheumatology - January 25, 2018 Category: Rheumatology Source Type: research

Multiple facets of ADA2 deficiency: Vasculitis, auto-inflammatory disease and immunodeficiency: A literature review of 135 cases from literature.
Authors: Fayand A, Sarrabay G, Belot A, Hentgen V, Kone-Paut I, Grateau G, Melki I, Georgin-Lavialle S Abstract Deficiency of adenosine deaminase 2 (DADA2) is a recently described auto-inflammatory disorder. It is an autosomal recessive inherited disease, caused by mutations in the ADA2 gene (formerly known as CECR1) encoding ADA2 enzyme. Besides its role in the purine metabolism, it has been postulated that ADA2 may act as a growth factor for endothelial cells and in the differenciation of monocytes. Thus, deficiency of ADA2 would lead to endothelial damage and a skewing of monocytes into M1 pro-inflammatory macro...
Source: Revue de Medecine Interne - December 25, 2017 Category: Internal Medicine Tags: Rev Med Interne Source Type: research

Acute methotrexate-related neurotoxicity and pseudo-stroke syndrome.
We describe five episodes of transient acute leukoencephalopathy mimicking a stroke, reported in the literature as "pseudo-stroke syndrome". Neurologic symptoms occurred 3-10 days after IV or IT methotrexate and manifested as aphasia and alternating sensorimotor deficit. The fluctuating symptomatology regressed completely within a few days. Brain MRI, which is essential for diagnosis, demonstrated early white matter diffusion restriction in the affected cerebral area. These anomalies disappeared in one week, while hyperintense T2 FLAIR signals developed in the corresponding brain areas. The long-term progression of thes...
Source: Archives de Pediatrie - November 13, 2017 Category: Pediatrics Authors: Deneux V, Leboucq N, Saumet L, Haouy S, Akbaraly T, Sirvent N Tags: Arch Pediatr Source Type: research

Attenuation of Myeloid Specific TGF β Signaling Induces Inflammatory Cerebrovascular Disease and Stroke.
Conclusions: Our studies show that TGFβ signaling in myeloid cells is required for maintenance of vascular health, and provide insight into inflammation-mediated cerebrovascular disease and stroke. PMID: 29051340 [PubMed - as supplied by publisher]
Source: Circulation Research - October 19, 2017 Category: Cardiology Authors: Hollander MC, Latour LL, Yang D, Ishii H, Xiao Z, Min Y, Ray-Choudhury A, Munasinghe J, Merchant AS, Lin PC, Hallenbeck J, Boehm M, Yang L Tags: Circ Res Source Type: research

Case report: Central nervous system involvement of human graft versus host diseaseReport of 7 cases and a review of literature
We report 7 cases of CNS-GvHD among which two had histological-proven disease. We reviewed 32 additional cases of CNS GvHD published in literature since 1990. In this cohort, 34 patients were transplanted for hematologic malignancies, and 5 for non-malignant hematopoiesis disorders. Of these patients, 25 had a history of chronic GvHD and immunosuppressive treatment had been decreased or discontinued in 14 patients before neurological symptoms onset. Median neurological disorder onset was 385 days [7-7320]. Patients had stroke-like episodes (n = 7), lacunar syndromes (n = 3), multiple sclerosis-like presentations (n...
Source: Medicine - October 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Investigating the Mechanisms of Methotrexate Neurotoxicity in Patients With Childhood Leukemia and Long-Term Survivors
Adverse neurological events are common (4-20%) during treatment for pediatric acute lymphoblastic leukaemia (ALL) and include seizures, stroke like syndrome and leukoencephalopathy. In addition, chronic neurotoxicity is emerging as a worrying late effect of treatment with long-term survivors experiencing decreased executive function, processing speed and memory function. Survivors are also at increased risk of experiencing learning difficulties, social withdrawal issues and inattention hyperactivity disorders.
Source: Clinical Lymphoma, Myeloma and Leukemia - September 1, 2017 Category: Hematology Authors: Victoria Forster, Jane Carr-Wilkinson, Deborah Tweddle, Sirintra Nakjang, Sanaa Choufani, Rosanna Weksberg, Frederik van Delft Source Type: research

Methotrexate ‐induced leukoencephalopathy presenting as stroke in the emergency department
Key Clinical Message Methotrexate‐induced leukoencephalopathy is to be considered as a potential etiology in any patient presenting with stroke‐like symptoms after receiving methotrexate. One of our cases suggests that the method of administration of the methotrexate can be IV or intrathecal and still results in leukoencephalopathy. Methotrexate‐induced leukoencephalopathy is to be considered as a potential etiology in any patient presenting with stroke‐like symptoms after receiving methotrexate. One of our cases suggests that the method of administration of the methotrexate can be IV or intrathecal and still resu...
Source: Clinical Case Reports - August 29, 2017 Category: General Medicine Authors: Maria Teresa Cruz ‐Carreras, Patrick Chaftari, Anna Shamsnia, Nandita Guha‐Thakurta, Carmen Gonzalez Tags: Case Report Source Type: research

Drug Aimed at Inflammation May Lower Risk of Heart Disease and Cancer
A milestone finding for researchers, the connection of inflammatory responses to such illnesses could open the door to new treatments.
Source: NYT Health - August 27, 2017 Category: Consumer Health News Authors: DENISE GRADY Tags: Brigham and Women's Hospital Lancet, The (Journal) Heart Lung Cancer Smoking and Tobacco Cholesterol Research Preventive Medicine Stroke Immune System Statins (Cholesterol-Lowering Drugs) Clinical Trials Methotrexate (Drug) Ridke Source Type: news

Capecitabine-induced acute toxic leukoencephalopathy.
Abstract A 45-year-old woman was treated by Capecitabine (Xeloda(®)) during 6days for breast cancer with metastatic bone lesions when she presented with nausea, headaches, muscle cramps, dysarthria and swallowing disorders. A stroke was first suspected. Brain CT was normal. MRI showed bilateral and symmetric high signal intensities of deep white matter, corpus callosum and corticospinal tracts on diffusion-weighted imaging and T2 fluid-attenuated inversion recovery (FLAIR) sequence, similar to 5-FU acute leukoencephalopathy. An acute toxic leukoencephalopathy was diagnosed prompting to discontinue capecitabine, w...
Source: Neurotoxicology - May 6, 2017 Category: Neurology Authors: Obadia M, Leclercq D, Wasserman J, Galanaud D, Dormont D, Sahli-Amor M, Psimaras D, Pyatigorskaya N, Law-Ye B Tags: Neurotoxicology Source Type: research

Stroke like syndrome and simple partial seizures secondary to intrathecal methotrexate use for the treatment of acute lymphocytic leukemia. (p6.181)
Conclusions:Our case may be the first reported of seizures and stroke like syndrome in the same patient for ALL treated with MTX. Clinicians should include Methotrexate induced leukoencephalopathy in their differential of seizures, stroke like syndrome and a combination of both. MRI DWI, ADC and FLAIR images should be included in the diagnostic evaluation of MTX induced encephalopathy especially with IT methotrexate.Disclosure: Dr. Fares has nothing to disclose. Dr. Silliman has received research support from Sanofi Genzyme, Biogen Idec, Bristol Myers and Novartis.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Fares, M.-A., Silliman, S. Tags: Neurologic Complications of Cancer Source Type: research

A Stroke Mimic: Methotrexate-induced Neurotoxicity in the Emergency Department
Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia. The treatment of ALL involves multimodality therapy, and methotrexate (MTX) remains a mainstay of treatment. A complication of MTX therapy includes acute, subacute, and chronic neurotoxocity. Signs and symptoms may range from headaches, dizziness, and mood disorders to seizures and stroke-like symptoms.
Source: The Journal of Emergency Medicine - January 13, 2017 Category: Emergency Medicine Authors: Patrick Rogers, Wilbur J. Pan, Richard A. Drachtman, Christopher Haines Tags: Clinical Communications: Pediatric Source Type: research

Stroke-like encephalopathy following high-dose intravenous methotrexate in an adolescent with osteosarcoma: a case report
ABSTRACT Chronic lymphocytic leukemia is characterized by clonal proliferation and progressive accumulation of B-cell lymphocytes that typically express CD19+, CD5+ and CD23+. The lymphocytes usually infiltrate the bone marrow, peripheral blood, lymph nodes, and spleen. The diagnosis is established by immunophenotyping circulating B-lymphocytes, and prognosis is defined by two staging systems (Rai and Binet) established by physical examination and blood counts, as well as by several biological and genetic markers. In this update, we present the recommendations from the Brazilian Group of Chronic Lymphocytic Leukemia for th...
Source: Revista Brasileira de Hematologia e Hemoterapia - December 29, 2016 Category: Hematology Source Type: research

Hickam's dictum versus ockham's razor
A 56-year-old man presented with evolving symptoms of left-sided weakness and fatigue over six months. Examination revealed spastic hemiparesis. MR brain imaging revealed confluent, oedematous white matter lesions in the right hemisphere without restricted diffusion or enhancement. Initial CSF analysis was unremarkable, including negative JC virus. Blood screen revealed a mild lymphopaenia. CT scanning of the viscera showed pulmonary changes which revealed, via transbronchial biopsy, non-caseating granulomata suggesting pulmonary sarcoidosis. High dose prednisolone was commenced following which the weakness improved. Metho...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Marchant, R., Bunting, E., Barritt, A., Good, C., Adams, N., Merve, A., Wickremaratchi, M. Tags: Immunology (including allergy), Neuroimaging, Stroke, Radiology, Surgical diagnostic tests, Radiology (diagnostics) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research