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Amphotericin B-Associated Leukoencephalopathy
Neurol 42:2005-2010, Walker,R.W.&Rosenblum,M.K., 1992
See this aricle in Pubmed
Article Abstract
We report instances of fatal leukoencephalopathy associated with the intravenous administration of the antifungal agent amphotercin B(AmB)to a 16-year-old girl treated for acute lymphoblastic leukemia amd a 22-year- old man who underwent a bone marrow transplatation 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 akinectic mutism. Neuroimaging studies disclosed diffuse nonenhancing abnormalities of the cerebral,particularly frontal,white matter that included hypodensity on CT and increased signal on T2-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 antobiotics such as AmB are potential leukotoxins.
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adverse drug reaction
akinetic mute
amphotericin B
antibiotics
antibiotics,neurologic complications with
bone marrow transplantation
CAT scan
CAT scan,abnormal
confusion
disorientation
leukoencephalopathy
mortality
MRI
MRI,abnormal
neuropathology
personality change
radiation therapy,CNS treatment and complications with
treatment of neurologic disorder
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