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Posterior reversible encephalopathy syndrome in a postpartum woman with acute lymphoblastic leukaemia after intrathecal methotrexate
  1. Craig Mescher,
  2. Arne Slungaard
  1. Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
  1. Correspondence to Dr Craig Mescher, mesc0014{at}


Posterior reversible encephalopathy syndrome (PRES) is the most common neurological complication occurring in children undergoing induction chemotherapy for acute lymphoblastic leukaemia (ALL) but is increasingly recognised to occur in adults as well. Here, we report a woman who presented with B-cell ALL (B-ALL) at the time of delivery and developed PRES 1 day after receiving intrathecal (IT) methotrexate (MTX) that rapidly resolved. She subsequently received IT MTX without recurrence of neurological symptoms. This case represents the first case of PRES in a postpartum B-ALL patient receiving IT MTX, demonstrates that re-treatment with MTX in this case could be done safely and highlights the risk of PRES in adults treated for B-ALL.

  • haematology (drugs and medicines)
  • haematology (incl blood transfusion)
  • pregnancy
  • chemotherapy
  • unwanted effects / adverse reactions

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  • Handling editor Seema Biswas

  • Contributors CAM analysed and interpreted the data, wrote a draft and made revisions of the manuscript and approved of the submitted version. AS analysed and interpreted the data, revised the manuscript and approved of the submitted version.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.