Moudgil S S, Riggs J E
Department of Neurology, West Virginia University Health Sciences Center, Morgantown 26506, USA.
Ann Pharmacother. 2000 Oct;34(10):1136-8. doi: 10.1345/aph.19396.
To report a case of fulminant neuropathy with severe quadriparesis associated with vincristine chemotherapy.
A 48-year-old white man with acute lymphoblastic leukemia was started on an induction chemotherapeutic regimen that included intravenous vincristine. He received a total of 6 mg of vincristine over two weeks during induction chemotherapy. Over the next two weeks, he developed a fulminant peripheral neuropathy with severe quadriparesis.
Although commonly associated with peripheral neuropathy, vincristine neurotoxicity only rarely involves instances of fulminant peripheral neuropathy with severe quadriparesis. Guillain-Barré syndrome is also associated with leukemia and may present as a fulminant peripheral neuropathy with severe quadriparesis.
Fulminant neuropathy with severe quadriparesis occurring in patients with leukemia being treated with vincristine (and who do not have coexistent Charcot-Marie-Tooth disease) is more likely due to Guillain-Barré syndrome than to vincristine neurotoxicity.
报告一例与长春新碱化疗相关的暴发性神经病伴严重四肢瘫的病例。
一名48岁的白人男性，患有急性淋巴细胞白血病，开始接受包含静脉注射长春新碱的诱导化疗方案。在诱导化疗期间的两周内，他共接受了6毫克长春新碱。在接下来的两周里，他出现了伴有严重四肢瘫的暴发性周围神经病。
虽然长春新碱通常与周围神经病相关，但长春新碱神经毒性很少涉及伴有严重四肢瘫的暴发性周围神经病病例。格林-巴利综合征也与白血病有关，可能表现为伴有严重四肢瘫的暴发性周围神经病。
在接受长春新碱治疗（且无并存的夏科-马里-图斯病）的白血病患者中发生的伴有严重四肢瘫的暴发性神经病，更可能是由格林-巴利综合征引起，而非长春新碱神经毒性。
