Subacute methotrexate neurotoxicity and cerebral venous sinus thrombosis in a 12-year-old with acute lymphoblastic leukemia and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism: homocysteine-mediated methotrexate neurotoxicity via direct endothelial injury.

Journal Article (Journal Article)

From as early as the 1970s methotrexate has been associated with disseminated necrotizing leukoencephalopathy and other neurotoxic sequelae. Yet, a clear mechanism for methotrexate-induced neurotoxicity has not been established. The authors describe the case of a 12-year-old male with acute lymphoblastic leukemia and a homozygous methylenetetrahydrofolate reductase C677T mutation, who developed subacute methotrexate-induced toxicity and cerebral venous thrombosis after receiving intrathecal methotrexate. The role of homocysteine as a possible mediator in methotrexate-induced neurotoxicity via direct endothelial injury is discussed.

Full Text

Duke Authors

Cited Authors

  • Mahadeo, KM; Dhall, G; Panigrahy, A; Lastra, C; Ettinger, LJ

Published Date

  • February 2010

Published In

Volume / Issue

  • 27 / 1

Start / End Page

  • 46 - 52

PubMed ID

  • 20121554

Electronic International Standard Serial Number (EISSN)

  • 1521-0669

Digital Object Identifier (DOI)

  • 10.3109/08880010903341904


  • eng

Conference Location

  • England