Cerebral venous thrombosis after first Methotrexate administration by lumbar puncture in a patient with large B cell lymphoma

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Published Oct 29, 2023
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Vol. 101 No. 7 (2023): Tunis med jul 2023

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Aicha Ben Kahla
Department of Hematology, Hedi Chaker Hospital, University of Sfax, Tunisia
Olfa Kassar
Department of Hematology, Hedi Chaker Hospital, University of Sfax, Tunisia
Khadija Moalla
Department of Neurology, Habib Bourguiba Hospital, University of Sfax,Tunisia
Yosra Fakhfakh
Department of Hematology. Hedi Chaker Hospital, University of Sfax, Tunisia
Yosr Hentati
Department of Medical Radiology, Hedi Chaker Hospital, University of Sfax, Tunisia
Moez Elloumi
Department of Hematology,Hedi Chaker Hospital, University of Sfax, Tunisia

Abstract

Cerebral venous thrombosis is a rare consequence of lumbar punctures for intrathecal therapy. We report a patient treated for diffuse large B cell lymphoma with cerebral venous thrombosis after intrathecal Methotrexate administration. In this patient, intrathecal treatment was discontinued and he was successfully treated with high-dose low-molecular-weight heparin subcutaneously.


Haematologist must be aware about neurological symptoms of cerebral venous thrombosis as a complication of lumbar puncture especially among patients with high coagulopathy state.


If neurological symptom occurs, patient should be referred early to neurologist to avoid fatal outcome and neurological deficit.

Keywords:

Cerebral venous thrombosis, diffuse large B cell lymphoma, intrathecal Methotrexate, lumbar puncture

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