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Acute onset flaccid quadriparesis in pediatric non-Hodgkin lymphoma: vincristine induced or Guillain-Barré syndrome?

Abstract
Immunological involvement of peripheral nervous system in non-Hodgkin lymphoma (NHL) is very rare and it may be difficult to differentiate it from vincristine-induced neuropathy. We report clinical and electrophysiological findings of an 8-year-old male with NHL who developed acute onset fulminant motor sensory autonomic neuropathy during induction chemotherapy which included vincristine. Characteristic clinical picture and nerve conduction studies favored Guillain-Barré syndrome. The patient improved rapidly with intravenous immunoglobulin and supportive care. It is possible that an immune mechanism damaged the peripheral nervous system in the patient without ruling out the adverse effects of vinca alkaloids.
AuthorsAnkur Bahl, Biswaroop Chakrabarty, Sheffali Gulati, K N Vykunta Raju, Ali Raja, Sameer Bakhshi
JournalPediatric blood & cancer (Pediatr Blood Cancer) Vol. 55 Issue 6 Pg. 1234-5 (Dec 01 2010) ISSN: 1545-5017 [Electronic] United States
PMID20544812 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antineoplastic Agents, Phytogenic
  • Immunoglobulins, Intravenous
  • Vincristine
Topics
  • Antineoplastic Agents, Phytogenic (adverse effects)
  • Child
  • Guillain-Barre Syndrome (complications)
  • Humans
  • Immunoglobulins, Intravenous (therapeutic use)
  • Lymphoma, Non-Hodgkin (complications, drug therapy)
  • Male
  • Palliative Care
  • Quadriplegia (etiology, pathology)
  • Treatment Outcome
  • Vincristine (adverse effects)

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