Article

Acute onset flaccid quadriparesis in pediatric non-Hodgkin lymphoma: vincristine induced or Guillain-Barré syndrome?

Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Pediatric Blood & Cancer (impact factor: 1.89). 12/2010; 55(6):1234-5. DOI:10.1002/pbc.22684 pp.1234-5
Source: PubMed

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.

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Keywords

8-year-old male
 
acute onset fulminant motor sensory autonomic neuropathy
 
Characteristic clinical picture
 
differentiate
 
electrophysiological findings
 
induction chemotherapy
 
intravenous immunoglobulin
 
nerve conduction studies
 
NHL
 
vinca alkaloids