Cerebral Microbleeds with Posterior Reversible Encephalopathy Syndrome: A Rare complication in Acute Lymphoblastic LeukaemiaCorrespondence Address :
Dr. Aravind Yogabalan,
140, Appinaickanpatti, Uthangarai, Krishnagiri-635207, Tamil Nadu, India.
Cerebral microbleeds are a rare entity usually seen in hypertensive microangiopathy or amyloid angiopathy. Its occurrence in Acute Lymphoblastic Leukaemia (ALL) has not been reported so far. Clinicians while treating patients should be aware of such complications for timely diagnosis and management. This is a case report on 19-year-old male, who was on treatment for ALL, under induction phase of the Berlin-Frankfurt-Munster-95 (BFM-95) regimen, who developed one episode of generalised tonic-clonic seizures. The MRI brain in T2 sequence showed hyperintense lesions in the white matter of occipital region, suggestive of Posterior Reversible Encephalopathy Syndrome (PRES). Susceptibility Weighted Imaging (SWI) showed multifocal areas of blooming in bilateral cerebral hemispheres suggestive of microbleeds. The fibrinogen level was very low strongly suggestive of L-Asparaginase induced microbleeds. The patient was treated with antiepileptic and cryoprecipitate transfusion to maintain fibrinogen levels and further doses of L-Asparaginase were withheld. He recovered without any neurological sequelae.
L-Asparaginase, Microangiopathy, Tonic-clonic seizures
Aravind Yogabalan, Karthick Udupa. CEREBRAL MICROBLEEDS WITH POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME: A RARE COMPLICATION IN ACUTE LYMPHOBLASTIC LEUKAEMIA. Journal of Clinical and Diagnostic Research [serial online] 2018 April [cited: 2018 Jul 21 ]; 12:XD01-XD02. Available from
Date of Submission: Oct 24, 2017
Date of Peer Review: Jan 09, 2018
Date of Acceptance: Jan 12, 2018
Date of Publishing: Apr 01, 2018
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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