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伪装成吉兰-巴雷综合征的意外鞘内注射长春新碱的临床表现

Clinical Presentation of Inadvertent Intrathecal Vincristine Masquerading Guillain-Barre Syndrome.

作者信息

Saha Agni Sekhar, Islam Md Fekarul, Bhattacharya Sukanta, Giri Prabhas Prasun

机构信息

Fortis Hospital, 30/H Mahendra Roy Lane, Kolkata, West Bengal 700046 India.

Institute of Child Health, Kolkata, India.

出版信息

Indian J Hematol Blood Transfus. 2016 Jun;32(Suppl 1):59-61. doi: 10.1007/s12288-016-0666-y. Epub 2016 Mar 12.

Abstract

Vincristine, a potent chemotherapeutic agent, is highly neurotoxic. If given intrathecally by accident it is almost always fatal. We are reporting a 6 year old girl with acute lymphoblastic leukaemia in complete remission, who was given inadvertent intrathecal Vincristine instead of Methotrexate. She developed gradually progressive quadriplegia and respiratory paralysis requiring prolonged mechanical ventilation, initially mimicking Guillain-Barre Syndrome, both clinically and electro-physiologically. She also developed progressive encephalopathy. The clinical deterioration subsequently plateaued without any significant improvement and after more than 5 months, she finally expired.

摘要

长春新碱是一种强效化疗药物,具有高度神经毒性。若意外鞘内注射,几乎总会致命。我们报告一名6岁急性淋巴细胞白血病完全缓解期女童,她被误将鞘内注射长春新碱当作甲氨蝶呤注射。她逐渐出现进行性四肢瘫痪和呼吸麻痹,需要长期机械通气,最初在临床和电生理方面都酷似吉兰-巴雷综合征。她还出现了进行性脑病。临床病情恶化随后趋于平稳,没有任何明显改善,5个多月后最终死亡。

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