Suicide attempt induced by drug‐induced leukoencephalopathy: A case report. Issue 4 (15th October 2021)

• Record Type: Journal Article
• Authors: Maehara, Ryo; Kawamata, Yasushi; Ichikawa, Motoshi; Mitani, Kinuko; Yasui‐Furukori, Norio; Shimoda, Kazutaka
• Is Part Of: Neuropsychopharmacology reports. Volume 41:Issue 4(2021)
• Page Start: 551
• Page End: 553
• Publication Date: 2021-10-15
• Subjects: leukoencephalopathy -- methotrexate -- MRI -- suicide attempt; Neuropsychopharmacology -- Periodicals; 615.78
• DOI: 10.1002/npr2.12214
• Languages: English
• ISSNs: 2574-173X

Abstract

Abstract: Background: Leukoencephalopathy is identified during the administration of anticancer drugs. Symptoms vary from neurological symptoms to psychiatric symptoms depending on the site of damage. There have been no previous reports of suicide attempts due to drug‐induced leukoencephalopathy. Case Presentation: The patient was diagnosed with diffuse large B‐cell lymphoma (DLBCL) infiltrating the pharyngeal lesion. Rituximab + methotrexate + oncovin + procarbazine (R‐MPV) therapy, a methotrexate‐containing chemotherapy, was initiated. At the end of the fifth course, the patient attempted suicide by hanging with an appliance cord, which was associated with delusion. A head MRI scan showed no evidence of lymphoma recurrence, but white matter lesions around the ventricles showed progression. Conclusion: We report the case of a patient in whom drug‐induced leukoencephalopathy related to methotrexate led to a suicide attempt. In addition to monitoring brain tumors, daily monitoring of psychiatric and neurological symptoms is important for patients with methotrexate‐induced encephalopathy. Abstract : MRI images revealed that the white matter lesions had progressed even after methotrexate administration was completed. The image taken after one dose of methotrexate also shows mild progression of white matter lesions.