Vincristine-induced peripheral neuropathy in a neonate with congenital acute lymphoblastic leukemia.
We report the case of a 46-day-old boy with a fulminant vincristine-induced peripheral neuropathy after treatment for congenital acute lymphoblastic leukemia. Flaccid paralysis developed at the end of the first phase of induction, requiring intubation and ventilation for 51 days. Treatment was initiated with levocarnitine, N-acetylcysteine, and pyridoxine and progressive reversal of the neuropathy occurred over the next 4 months. Potential differences in pathogenesis and presentation of vincristine neurotoxicity and Guillian-Barre syndrome in the neonate are discussed.
Baker
Steven K
SK
Department of Medicine, Physical Medicine & Neurology, Neuromuscular Disease Clinic, McMaster University Medical Centre, McMaster University, Hamilton, Ontario, Canada. bakersk@mcmaster.ca
Lipson
David M
DM
D000111:Acetylcysteine / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D002331:Carnitine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000188:drug therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000151:congenital* / Q000188:drug therapy*; D011736:Pyridoxine / Q000627:therapeutic use; D014750:Vincristine / Q000009:adverse effects*; D014803:Vitamin B Complex / Q000627:therapeutic use
D000972:Antineoplastic Agents, Phytogenic; D016166:Free Radical Scavengers; D014803:Vitamin B Complex; D014750:Vincristine; D011736:Pyridoxine; D002331:Carnitine; D000111:Acetylcysteine