Reactions 1680, p321 - 2 Dec 2017 Stroke: case report A 7-year-old girl developed stroke during treatment with thalidomide [route and time to reactions onset not stated]. The girl presented with a 2 weeks history of diffuse dull aching type headache associated with infrequent episodes of non-bilious and non-projectile vomiting. She also had generalised weakness of all 4 extremities and an unsteady gait. Her parents had thalassemia traits. At the age of 6 months, she was diagnosed with β-thalassemia major and had been receiving monthly packed cell blood transfusions. She had right lateral rectus palsy and bilateral papilloedema. Other cranial nerve functions were normal. Her laboratory examinations showed anaemia with haemoglobin 8.6g%, and normal blood counts, glucose and serum electrolytes. Her brain MRI revealed a hyperintense focus in the left cerebellum with a restriction on apparent diffusion coefficient mapping, consistent with an infarct. A probability of thalassemia major itself leading to thrombosis or a CNS infection causing a vasculitis stroke was considered. She was treated with anti- oedema measures to decrease her increased intracranial tension, and anticoagulant therapy with aspirin and low molecular weight heparin. A progressive improvement of the symptoms with a stable general condition was observed. She had been receiving thalidomide 10 mg/kg/day over the past 2 months to decrease frequency of the transfusion requirement. The girl’s thalidomide therapy was stopped. She was discharged on aspirin and unspecified iron chelating agents. On follow-up, her condition recovered completely with no residual symptoms. Author comment: "We report a case of stroke in a β- thalassemic child who had received a course of thalidomide." Gunaseelan S, et al. Thalidomide-induced Stroke in a Child With Thalassemia Major. Journal of Pediatric Hematology/Oncology 39: e519-e520, No. 8, Nov 2017. Available from: URL: http://doi.org/10.1097/MPH.0000000000000860 - Unknown 803283945 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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