Hematomielia in acute leukemia patients. Two clinical cases.

Tereshchenko G.V., Politova E.A., Serdyuk O.A., Krasnov A.S., Petrova U.N., Smirnova N.V., Novichkova G.A.

Hematomielia is a hemorrhage into the substance of the spinal cord. The most common causes of hematomielia are injures, vessel malformations and hemorrhagic diathesis. Hematomielia leads to severe neurological complications, mostly leaving persistent neurological deficit. We present two clinical cases of hematomielia in adolescent patients with acute mye-loid and lymphoblastic leukemia. The most frequent causes of bleeding in the spinal cord are spinal injury and/or spinal cord lesions of vessels (cavernoma, arteriovenous malformations), congenital or acquired hemorrhagic diathesis, vasculitis, receiving anticoagulants. Hematomielia rarely occurs after the hemorrhage into siringomielitic cyst or tumor. He-matomielia in leukemia is described in rare cases, as opposed to bleeding in the brain. In some cases, the hematomielia develops as a complication of medical procedures such as epidural anesthesia and lumbar puncture, including acute leukemia. Some cases of sponta-neous hematomielia are described. Hematomielia risk factors are considered to be: the mus-cle tension, atherosclerosis, the irradiation of the spinal cord, alcohol. In pediatric practice, described the association of hematomielia and traumatic asphyxia syndrome (Olivier). In our cases clinical hematomielia developed on the background of coagulopathy caused by acute leukemia. The exact cause of hematomielia in the first case was the bleeding after the removing of myeloid infiltration of the thoracic region of the spine, in the second one - after the lumbar puncture. Despite ongoing therapy, and clinical remission of the underlying disease both patients developed neurological symptoms varying from tetra paresis to the extent lower paraplegia, conductive disorders of sensitivity, rough pelvic disorders.
Federal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev. Moscow, Russia.


 

 

 

 

 

 

Keywords:hematomielia, spinal cord, myelopathy, MRI.

 

Corresponding author:Tereshchenko G.V., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Tereshchenko G.V., Politova E.A., Serdyuk O.A., Krasnov A.S., Petrova U.N., Smirnova N.V., Novichkova G.A. Hematomielia in acute leukemia patients. Two clinical cases. REJR 2017; 7(4):202-210. DOI:10.21569/2222-7415-2017-7-4-202-210.

Received: 29.03.2017 Accepted: 05.10.2017