Vincristine treatment triggering the expression of asymptomatic Charcot-Marie-Tooth disease.
A 16-year-old male suffering from Ewing's sarcoma of the pelvis was treated with vincristine as part of his chemotherapeutic protocol. The boy was never known to suffer from any neurological problems. His father had a mild limp, attributed to prolonged "taxi driving," that was never investigated medically. The first course of treatment, which included 2 mg of vincristine, resulted in clinical improvement. However, at the same time the patient developed severe weakness of both upper and lower limbs, areflexia, and gradually a pes cavus deformity. Nerve conduction studies were suggestive of severe peripheral sensorimotor neuropathy, axonal and demyelinative. A definite diagnosis of Charcot-Marie-Tooth was confirmed by molecular analysis showing the typical duplication of 1.5 megabases at 17 p11.2. This unique manifestation of vincristine neurotoxicity is reported and discussed.
Neumann
Y
Y
Institute of Hematology, Chain Sheba Medical Center, Tel-Hashomer, Israel.
Toren
A
A
Rechavi
G
G
Seifried
B
B
Shoham
N G
NG
Mandel
M
M
Kenet
G
G
Sharon
N
N
Sadeh
M
M
Navon
R
R
D000293:Adolescent; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy*; D002607:Charcot-Marie-Tooth Disease / Q000139:chemically induced* / Q000235:genetics; D002886:Chromosomes, Human, Pair 17; D005530:Foot Deformities / Q000139:chemically induced; D005786:Gene Expression Regulation; D006801:Humans; D007512:Ischium / Q000473:pathology; D008297:Male; D018908:Muscle Weakness / Q000139:chemically induced; D009431:Neural Conduction / Q000187:drug effects; D011630:Pubic Bone / Q000473:pathology; D012021:Reflex, Abnormal / Q000187:drug effects; D012512:Sarcoma, Ewing / Q000188:drug therapy*; D014750:Vincristine / Q000009:adverse effects* / Q000627:therapeutic use
D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine