Massive myelinolytic leukoencephalopathy in a patient medicated with low-dose oral methotrexate for rheumatoid arthritis: An autopsy report

Acta Neuropathologica

Volumn 114, Issue 4, 2007, Pages 425-430

  Yokoo, Hideaki ^a   Nakazato, Yoichi ^a   Harigaya, Yasuo ^b   Sasaki, Natsu ^b   Igeta, Yukifusa ^b   Itoh, Hideaki ^b  

^a GUNMA UNIVERSITY GRADUATE SCHOOL OF MEDICINE   (Japan)

^b MAEBASHI RED CROSS HOSPITAL   (Japan)

Author keywords

Autopsy; Demyelination; Leukoencephalopathy; Methotrexate; Rheumatoid arthritis

Indexed keywords

LOXOPROFEN; METHOTREXATE; PREDNISOLONE;

AGED; ARTICLE; ASTROCYTOSIS; AUTOPSY; BRAIN STEM; CAPSULA INTERNA; CASE REPORT; CLINICAL PROTOCOL; DEATH; DEMYELINATION; DISEASE COURSE; DISEASE SEVERITY; DRUG BLOOD LEVEL; FEMALE; FRONTAL LOBE; HOSPITAL ADMISSION; HUMAN; HUMAN TISSUE; LEUKOENCEPHALOPATHY; LOW DRUG DOSE; NUCLEAR MAGNETIC RESONANCE IMAGING; PONS; PRIORITY JOURNAL; RHEUMATOID ARTHRITIS; SYMPTOM; TEMPORAL LOBE; WHITE MATTER;

ADENOCARCINOMA; ADMINISTRATION, ORAL; AGED; ANTI-INFLAMMATORY AGENTS; ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL; ANTIRHEUMATIC AGENTS; ARTHRITIS, RHEUMATOID; BRAIN DISEASES; DEMYELINATING DISEASES; FEMALE; HUMANS; LUNG NEOPLASMS; MAGNETIC RESONANCE IMAGING; METHOTREXATE; PHENYLPROPIONATES; PREDNISOLONE;

EID: 34848849304     PISSN: 00016322     EISSN: None     Source Type: Journal    
DOI: 10.1007/s00401-007-0214-9     Document Type: Article

References (27)

1. Adams RD, Victor M, Mancall EL (1959) Central pontine myelinolysis: A hitherto undescribed disease occurring in alcoholic and malnourished patients. AMA Arch Neurol Psychiatry 81:154-172
2. Bleyer WA, Drake JC. Chabner BA (1973) Neurotoxicity and elevated cerebrospinal fluid methotrexate concentration in meningeal leukaemia. N Eng J Med 289:770-773
3. Groff GD, Shenberger KN, Wilke WS, Taylor TH (1983) Low dose oral methotrexate in rheumatoid arthritis: An uncontrolled trial and review of the literature. Semin Arthritis Rheum 12:333-347
4. Hoffmeister RT (1983) Methotrexate therapy for rheumatoid arthritis: 15 years' experience. Am J Med 75(Suppl 6A):69-73
5. Kay HE, Knapton PJ, O'Sullivan JP, Wells DG, Harris RF, Innes EM, Stuart J, Schwartz FC, Thompson EN (1972) Encephalopathy in acute leukaemia associated with methotrexate therapy. Arch Dis Child 47:344-354
6. Kleinschmidt-Demasters BK, Rojiani AM, Filley CM (2006) Central and extrapontine myelinolysis: Then and now. J Neuropathol Exp Neurol 65:1-11
7. Kremer JM, Lee JK (1986) The safety and efficacy of the use of methotrexate in long-term therapy in rheumatoid artiritis. Arthritis Rheum 29:822-831
8. Lampl C, Yazdi K (2002) Central pontine myelinolysis. Eur Neurol 47:3-10
9. Linnebank M, Pels H, Kleczar N, Farmand S, Fliessbach K, Urbach H, Orlopp K, Klockgether T, Schmidt-Wolf IG, Schlegel U (2005) MTX-induced white matter changes are associated with polymorphisms of methionine metabolism. Neurology 64:912-913
10. Meadows AT, Evans AE (1976) Effects of chemotherapy on the central nervous system: A study parenteral methotrexate in long-term survivors of leukemia and lymphoma in childhood. Cancer 37:1079-1085
11. Nakazato Y, Ishida Y, Morimatsu M (1980) Disseminated necrotizing leukoencephalopathy. Acta Pathol Jpn 30:659-670
12. Nakazato Y, Ishizeki J, Takahashi K, Yamaguchi H, Kamei T, Mori T (1982) Localization of S-100 protein and glial fibrillary acidic protein-related antigen in pleomorphic adenoma of the salivary glands. Lab Invest 46:621-626
13. Nakazato Y, Sasaki A, Hirato J, Ishida Y (1987) Monoclonal antibodies which recognize phosphorylated and nonphosphorylated epitopes of neurofilament protein. Biomed Res 8:369-376
14. Price RA, Jamieson PA (1975) The central nervous system in childhood leukemia. II. Subacute leukoencephalopathy. Cancer 35:306-318
15. Price RA, Birdwell DA (1978) The central nervous system in childhood leukemia. III. Mineralizing microangiopathy and dystrophic calcification. Cancer 42:717-728
16. Prineas JW, McDonald WI, Franklin RJM (2002) Demyelinating diseases. In: Graham DI, Lantos PL (eds) Greenfield's neuropathology, 7th edn. Arnold, London, pp 471-550
17. Ramaekers VT, Reul J, Kusenbach G, Thron A, Heimann G (1997) Central pontine myelinolysis associated with acquired folate depletion. Neuropediatrics 28:126-130
18. Rubinstein LJ, Herman MM, Long TF, Wilbur JR (1975) Disseminated necrotizing leukoencephalopathy: A complication of treated central nervous system leukemia and lymphoma. Cancer 35:291-305
19. Steinsson K, Weinstein A, Korn J, Abeles M (1982) Low dose methotrexate in rheumatoid arthritis. J Rheumatol 9:860-866
20. van Ede AE, Laan RF, Rood MJ, Huizinga TW, van de Laar MA, van Denderen CJ, Westgeest TA, Romme TC, de Rooij DJ, Jacobs MJ, de Boo TM, van der Wilt GJ, Severens JL, Hartman M, Krabbe PF, Dijkmans BA, Breedveld FC, van de Putte LB (2001) Effect of folic or folinic acid supplementation on the toxicity and efficacy of methotrexate in rheumatoid arthritis: A forty-eight week, multicenter, randomized, double-blind, placebo-controlled study. Arthritis Rheum 44:1515-1524
21. Weinblatt ME (1985) Toxicity of low dose methotrexate in rheumatoid arthritis. J Rheumatol 12(Suppl 12):35-39
22. Weinblatt ME, Coblyn JS, Fox DA, Fraser PA, Holdsworth DE, Glass DN, Trentham DE (1985) Efficacy of low dose methotrexate in rheumatoid arthritis. N Engl J Med 312:818-822
23. Weiss HD, Walker MD, Wiernik PH (1974) Neurotoxicity of commonly used antineoplastic agents (first of two parts). N Engl J Med 291:75-81
24. Wernick R, Smith DL (1989) Central nervous system toxicity associated with weekly low dose methotrexate treatment. Arthritis Rheum 32:770-775
25. Wessels JA, de Vries-Bouwstra JK, Heijmans BT, Slagboom PE, Goekoop-Ruiterman YP, Allaart CF, Kerstens PJ, van Zeben D, Breedveld FC, Dijkmans BA, Huizinga TW, Guchelaar HJ (2006) Efficacy and toxicity of methotrexate in early rheumatoid arthritis are associated with single-nucleotide polymorphisms in genes coding for folate pathway enzymes. Arthritis Rheum 54:1087-1095
26. Willkens RF, Watson MA, Paxson CS (1980) Low dose pulse methotrexate therapy in rheumatoid arthritis. J Rheumatol 7:501-505
27. Worthley SG, McNeil JD (1996) Leukoencephalopathy in a patient taking low dose oral methotrexate therapy for rheumatoid arthritis. J Rheumatol 22:335-337