[P3-36] 3 cases report of acute lymphocyte leukemia onset with neurological symptoms
[Objective]: Summarize the clinical features of leukemia patients onset with neurological symptoms and have no sufficient evidence of central nervous system leukemia(CNSL),discuss possible pathogenesis. [Method]: We enrolled 3 ALL patients who firstly admitted to neurological ward because of neurological symptoms, compared their clinical features, laboratory tests and disease development, bring up possible pathogenesis. [Results]: Abnormal neurological symptoms including seizure, weakness. All were sudden onset, had recurrent nature, and accompanied with prominent conscious disturbance. They had multiple organs involved. Their MRI showed localized or diffuse abnormal signal mainly affect cortex, and returned to normal without chemotherapy. They were all firstly misdiagnosed as “metabolic disease”in a long time. [Conclusion]: Leukemia onset with neurology symptoms are not common to detect, always misdiagnosed, usually had abnormal findings in peripheral blood, even not prominent, should pay attention and do marrow puncture if necessary. They all had no solid evidence of CNSL, especially the abnormal signals in MRI could disappear without chemotherapy. Their clinical features and image abnormal resembled CNS small vessel vasculitis, which could be suspect to paraneoplastic neurologic syndrome. Our finding challenge the diagnostic criteria which take all ALL patients with MRI abnormal signal as CNSL and perform chemotherapy of high-risk protocol, do unnecessary harms.