Amphotericin B-associated leukoencephalopathy Journal Article
| Authors: | Walker, R. W.; Rosenblum, M. K. |
| Article Title: | Amphotericin B-associated leukoencephalopathy |
| Abstract: | we report instances of fatal leukoencephalopathy associated with the intravenous administration of the antifungal agent amphotericin B (AmB) to a 16–year–old girl treated for acute lymphoblastic leukemia and a 22–year–old man who underwent bone marrow transplantation for a myelodysplastic syndrome. Both received AmB in association with cranial irradiation and developed a subacutely evolving neurologic disorder characterized by personality change and confusion rapidly progressing to akinetic mutism. Neuroimaging studies disclosed diffuse nonenhancing abnormalities of thecerebral, particularly frontal, white matter that included hypodensity on CT and increasedsignal on T–weighted MRI. Postmortem examinations demonstrated a diffuse, noninflammatory leukoencephalopathy with florid astrogliosis, demyelination, and infiltration of the hemispheric white matter by foamy macrophages. In neither case was there evidence of opportunistic infection or neoplastic infiltration of the nervous system. We review the evidence that polyene macrolide antibiotics such as AmB are potential leukotoxins.©1992 American Academy of Neurology. |
| Keywords: | adolescent; adult; histopathology; case report; brain radiation; nuclear magnetic resonance imaging; magnetic resonance imaging; computer assisted tomography; acute lymphoblastic leukemia; confusion; myelodysplastic syndrome; brain; brain diseases; autopsy; bone marrow transplantation; leukoencephalopathy; drug induced disease; white matter; intravenous drug administration; myelodysplastic syndromes; personality disorder; amphotericin b; akinetic mutism; leukemia, lymphocytic, acute; human; male; female; priority journal; article |
| Journal Title: | Neurology |
| Volume: | 42 |
| Issue: | 10 |
| ISSN: | 0028-3878 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1992-10-01 |
| Start Page: | 2005 |
| End Page: | 2010 |
| Language: | English |
| PUBMED: | 1407584 |
| PROVIDER: | scopus |
| DOI: | 10.1212/wnl.42.10.2005 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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