Hiperlökositozu Olan Çocuk Hastada Santral Venöz Kateterizasyon Sırasında Gelişen Geçici Nörolojik Komplikasyon

Gülsen Keskin; Mine Akın; Sengül Özmert; Devrim Tanıl Kurt; Sibel Saydam; Yeşim Andıran Şenaylı; Pınar Özışık; Gülşah Bayram; Mine Akın

Case Report

Turk J Pediatr Dis 2017; 11(1): 65-68.

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Transient Neurological Complication During Central Venous Catheterization in a Child with Hyperleukocytosis

Authors

Gülsen Keskin

Mine Akın

Sengül Özmert

Devrim Tanıl Kurt

Sibel Saydam

Yeşim Andıran Şenaylı

Pınar Özışık

Gülşah Bayram

Mine Akın

Affiliations

Turk J Pediatr Dis 2017; 11(1): 65-68.

Published: April 1, 2017

Abstract

Hyperleukocytosis is seen in 5-20% of childhood leukemia cases and it is a poor prognostic factor. Leukapheresis is an effective emergency treatment method by reducing the number of blasts and control of neurological symptoms. Here we report a pediatric patient whose physical status was ASA IVE. He was diagnosed as acute leukemia and had neurologic deterioration together with late recovery from anesthesia after central venous catheterization. Morbidity and mortality of central venous catheterization, which is necessary for leukapheresis treatment, is high. Therefore, all the risks of the disorder and the central catheterization procedure should be described in detail to the family by clinician and the anesthesiologist during preoperative evaluation. We suggest using local anesthesia during this procedure in suitable cases and avoiding sedation or general anesthesia. When there is disorientation, we must remember that this can be a sign of a cerebrovascular event

Keywords: Child, Leukapheresis, Central venous catheterization

References

İrken G, Ören H, Öniz H, Çetingül N, Vergin C, Atabay B, et al. Hyperleukocytosis in childhood acute lymphoblastic leukemia: Complications and treatment outcome. Turk J Hematol 2006; 23:142-6.
Apak H, Karaman S, Celkan T, Özkan A, Canbolat A, Yantri L, ve ark. Akut lösemili hastalarda hiperlökositoz tedavisinde basit ve etkili kan değişimi yöntemi (ön sonuçlar). Türk Ped Arş 2008;43:24- 8.
Maurer HS, Steinherz PG, Gaynon PS, Finklestein JZ, Sather HN, Reaman GH, et al. The effect of initial management of hyperleukocytosis on early complications and outcome of children with acute lymphoblastic leukemia. J Clin Oncol 1988;6:1425-32.
Doğan M, Sal E, Açıkgöz M, Bora A, Öner AF. Lökostaz sonrası intrakraniyal kanama gelişen akut myeloid lösemi’li (AML) bir olgu sunumu. Van Tıp Dergisi 2008;15:30-3.
Porcu P, Farag S, Marcucci G, Cataland SR, Kennedy MS, Bissell M. Leukocytoreduction for acute leukemia. Ther Apher 2002;6:399- 400.
Strauss RA, Gloster ES, McCallister JA, Jimenez JF, Neuberg RW, Berry DH. Acute cytoreduction techniques in the early treatment of hyperleukocytosis associated with childhood hematologic malignancies. Med Pediatr Oncol 1985;13:346-51.
Porcu P, Danielson CFM, Orazi A, Buckwalter K, Lurito J, Skipworth E, et al. Acute lymphoblastic leukemia with hyperleukocytosis (HL) and supratentorial hemorrhage treated with leukapheresis. J Clin Apheresis 1998;13:82.
Eisen LA, Narasimhan M, Berger JS, Mayo PH, Rosen MJ, Schneider RF. Mechanical complications of central venous catheters. J Intensive Care Med 2006;21:40-6.
Koroglu M, Demir M, Koroglu BK, Sezer MT, Akhan O, Yildiz H, et al. Percutaneous placement of central venous catheters: comparing the anatomical landmark method with the radiologically guided technique for central venous catheterization through the internal jugular vein in emergent hemodialysis patients. Acta Radiol 2006;47:43-7.
Bo-Linn GW, Anderson DJ, Anderson KC, McGoon MD. Percutaneous central venous catheterization performed by medical house officers: A prospective study. Cath Cardiovasc Diagn 1982;8:23-29.

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How to cite

Keskin G, Akın M, Özmert S, Kurt DT, Saydam S, Şenaylı YA, et al. Transient Neurological Complication During Central Venous Catheterization in a Child with Hyperleukocytosis. Turk J Pediatr Dis [Internet]. 2017 Apr. 1 [cited 2025 May 24];11(1):65-8. Available from: https://turkjpediatrdis.org/article/view/481

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[ref1] İrken G, Ören H, Öniz H, Çetingül N, Vergin C, Atabay B, et al. Hyperleukocytosis in childhood acute lymphoblastic leukemia: Complications and treatment outcome. Turk J Hematol 2006; 23:142-6.

[ref2] Apak H, Karaman S, Celkan T, Özkan A, Canbolat A, Yantri L, ve ark. Akut lösemili hastalarda hiperlökositoz tedavisinde basit ve etkili kan değişimi yöntemi (ön sonuçlar). Türk Ped Arş 2008;43:24- 8.

[ref3] Maurer HS, Steinherz PG, Gaynon PS, Finklestein JZ, Sather HN, Reaman GH, et al. The effect of initial management of hyperleukocytosis on early complications and outcome of children with acute lymphoblastic leukemia. J Clin Oncol 1988;6:1425-32.

[ref4] Doğan M, Sal E, Açıkgöz M, Bora A, Öner AF. Lökostaz sonrası intrakraniyal kanama gelişen akut myeloid lösemi’li (AML) bir olgu sunumu. Van Tıp Dergisi 2008;15:30-3.

[ref5] Porcu P, Farag S, Marcucci G, Cataland SR, Kennedy MS, Bissell M. Leukocytoreduction for acute leukemia. Ther Apher 2002;6:399- 400.

[ref6] Strauss RA, Gloster ES, McCallister JA, Jimenez JF, Neuberg RW, Berry DH. Acute cytoreduction techniques in the early treatment of hyperleukocytosis associated with childhood hematologic malignancies. Med Pediatr Oncol 1985;13:346-51.

[ref7] Porcu P, Danielson CFM, Orazi A, Buckwalter K, Lurito J, Skipworth E, et al. Acute lymphoblastic leukemia with hyperleukocytosis (HL) and supratentorial hemorrhage treated with leukapheresis. J Clin Apheresis 1998;13:82.

[ref8] Eisen LA, Narasimhan M, Berger JS, Mayo PH, Rosen MJ, Schneider RF. Mechanical complications of central venous catheters. J Intensive Care Med 2006;21:40-6.

[ref9] Koroglu M, Demir M, Koroglu BK, Sezer MT, Akhan O, Yildiz H, et al. Percutaneous placement of central venous catheters: comparing the anatomical landmark method with the radiologically guided technique for central venous catheterization through the internal jugular vein in emergent hemodialysis patients. Acta Radiol 2006;47:43-7.