Acute onset flaccid quadriparesis in pediatric non-Hodgkin lymphoma: vincristine induced or Guillain-Barré syndrome?
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.
Bahl
Ankur
A
Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Chakrabarty
Biswaroop
B
Gulati
Sheffali
S
Raju
K N Vykunta
KN
Raja
Ali
A
Bakhshi
Sameer
S
D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D002648:Child; D020275:Guillain-Barre Syndrome / Q000150:complications*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000188:drug therapy*; D008297:Male; D010166:Palliative Care; D011782:Quadriplegia / Q000209:etiology* / Q000473:pathology; D016896:Treatment Outcome; D014750:Vincristine / Q000009:adverse effects*
D000972:Antineoplastic Agents, Phytogenic; D016756:Immunoglobulins, Intravenous; D014750:Vincristine