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Vincristine-related neuropathy versus acute inflammatory demyelinating polyradiculoneuropathy in children with acute lymphoblastic leukemia.

Abstract
The objective of this study was to evaluate whether electroneurography could help in differentiating between vincristine-induced neuropathy and acute inflammatory demyelinating polyradiculoneuropathy. We performed electroneurography in 7 children from September 2006 to March 2009 admitted to receive chemotherapy including vincristine for acute lymphoblastic leukemia, in whom severe acute limb weakness developed, suggesting vincristine-induced neuropathy. Three of 7 patients had electroneurography, suggesting acute inflammatory demyelinating polyradiculoneuropathy. They received intravenous immunoglobulins without discontinuing chemotherapy, and within 10 days their electroclinical conditions improved. Although electroneurography showed only absent F waves, preventing us from reaching a definitive neurophysiological diagnosis of acute inflammatory demyelinating polyradiculoneuropathy, children's presenting clinical manifestations, their disease course, and rapid and complete recovery after intravenous immunoglobulins argued strongly in its favor. A prompt, correct differential diagnosis of vincristine neuropathy and acute inflammatory demyelinating polyradiculoneuropathy in patients with acute lymphoblastic leukemia receiving vincristine is essential to improve disease outcome and prolong life expectancy.
AuthorsFrancesco Brigo, Rita Balter, Pierluigi Marradi, Monica Ferlisi, Ada Zaccaron, Antonio Fiaschi, Emma Frasson, Laura Bertolasi
JournalJournal of child neurology (J Child Neurol) Vol. 27 Issue 7 Pg. 867-74 (Jul 2012) ISSN: 1708-8283 [Electronic] United States
PMID22241706 (Publication Type: Journal Article)
Chemical References
  • Antineoplastic Agents, Phytogenic
  • Immunoglobulins
  • Vincristine
Topics
  • Antineoplastic Agents, Phytogenic (adverse effects)
  • Child
  • Child, Preschool
  • Electric Stimulation (methods)
  • Female
  • Functional Laterality (drug effects)
  • Guillain-Barre Syndrome (diagnosis, drug therapy)
  • Humans
  • Immunoglobulins (administration & dosage)
  • Male
  • Neural Conduction (drug effects, physiology)
  • Peroneal Nerve (physiopathology)
  • Polyneuropathies (chemically induced, diagnosis)
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy)
  • Reaction Time (drug effects)
  • Retrospective Studies
  • Time Factors
  • Vincristine (adverse effects)

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