title: 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.
authors.affiliation: Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona, Italy. dr.francescobrigo@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Brigo
authors.forename: Rita
authors.initials: R
authors.lastname: Balter
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Marradi
authors.forename: Monica
authors.initials: M
authors.lastname: Ferlisi
authors.forename: Ada
authors.initials: A
authors.lastname: Zaccaron
authors.forename: Antonio
authors.initials: A
authors.lastname: Fiaschi
authors.forename: Emma
authors.initials: E
authors.lastname: Frasson
authors.forename: Laura
authors.initials: L
authors.lastname: Bertolasi
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004558:Electric Stimulation / Q000379:methods; D005260:Female; D007839:Functional Laterality / Q000187:drug effects; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage; D008297:Male; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D010543:Peroneal Nerve / Q000503:physiopathology; D011115:Polyneuropathies / Q000139:chemically induced* / Q000175:diagnosis*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D011930:Reaction Time / Q000187:drug effects; D012189:Retrospective Studies; D013997:Time Factors; D014750:Vincristine / Q000009:adverse effects*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D007136:Immunoglobulins; D014750:Vincristine