J Korean Neurol Assoc.  2000 Jan;18(1):77-79.

A Case of Diffuse Leukoencephalopathy Following Low Dose Intravenous Methotrexate Therapy

• Seo DW
• Jung PW
• Oh KM
• Kim HY
• Moon SY

Abstract

Diffuse leukoencephalopathy is a well-known complication of methotrexate in intrathecal or high dose intravenous administration, especially when it is combined with cranial radiation therapy. However, low dose intravenous methotrexate induced leukoencephalopathy has not been reported previously. A 46-year-old female was administered intravenous methotrexate and 5-fluorouracil with oral cyclophosphamide after a modified radical mastectomy for breast cancer. After six cycles of chemotherapy, she developed rapidly progressing dementia and upper motor neuron signs. Brain MRI showed bilaterally symmetric white matter lesion without gadolinium enhancement. Laboratory investiga-tion showed no evidence of brain metastasis. This case suggests that low dose intravenous methotrexate can induce dif-fuse leukoencephalopathy.

Keyword

Leukoencephalopathy; Methotrexate; Breast cancer

MeSH Terms

Administration, Intravenous
Brain
Breast Neoplasms
Cyclophosphamide
Dementia
Drug Therapy
Female
Fluorouracil
Gadolinium
Humans
Leukoencephalopathies*
Magnetic Resonance Imaging
Mastectomy, Modified Radical
Methotrexate*
Middle Aged
Motor Neurons
Neoplasm Metastasis
Cyclophosphamide
Fluorouracil
Gadolinium
Methotrexate