title: 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.
authors.affiliation: Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ankur
authors.initials: A
authors.lastname: Bahl
authors.forename: Biswaroop
authors.initials: B
authors.lastname: Chakrabarty
authors.forename: Sheffali
authors.initials: S
authors.lastname: Gulati
authors.forename: K N Vykunta
authors.initials: KN
authors.lastname: Raju
authors.forename: Ali
authors.initials: A
authors.lastname: Raja
authors.forename: Sameer
authors.initials: S
authors.lastname: Bakhshi
mesh_terms: 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*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D016756:Immunoglobulins, Intravenous; D014750:Vincristine