Karki Kshitiz, Adhikari Sugat, Shrestha Suraj, Bhandari Jenish, Baral Bidisha, Baral Aastha
Annapurna Neurological Institute and Allied Sciences.
Shreegaun Primary Health Care Center, Dang.
Ann Med Surg (Lond). 2024 Mar 12;86(5):3082-3085. doi: 10.1097/MS9.0000000000001937. eCollection 2024 May.
Cytarabine, a pyrimidine analogue, is commonly used to treat multiple haematological conditions, such as acute leukaemias and lymphomas. One of the rare and less reported complications of cytarabine is peripheral neuropathy, in which peripheral nerves are damaged, often causing weakness, numbness, and pain, usually in the hands and feet.
The authors report the case of a 17-year-old male who developed a gradual onset of weakness and sensory loss in all four limbs during treatment with a conventional dose of cytarabine for acute myeloid leukaemia. Cytarabine was discontinued after the development of symptoms, and his motor and sensory functions gradually improved over the course of 3 months.
Alongside some well-known side effects of cytarabine, including bone marrow suppression, cerebellar syndrome, and cardiotoxicity, peripheral neuropathy is one of the uncommon side effects of cytarabine. Diagnosis includes identifying and grading the severity of chemotherapy-induced peripheral neuropathy (CIPN) through clinical assessment and nerve conduction studies. Management includes withdrawing the chemotherapeutic agent and supportive treatment with drugs such as duloxetine. Recent studies also favour the use of acupuncture and sensorimotor-based exercise intervention for the management of CIPN.
This case report has been prepared in line with the SCARE 2023 criteria.
Although rare, even a conventional dosage of cytarabine can cause peripheral neuropathy, and routine neuromuscular examinations can help in the early diagnosis and intervention to limit further progression and reverse the course of the disease.
阿糖胞苷是一种嘧啶类似物，常用于治疗多种血液系统疾病，如急性白血病和淋巴瘤。阿糖胞苷罕见且报道较少的并发症之一是周围神经病变，即周围神经受损，通常会导致手足无力、麻木和疼痛。
作者报告了一例17岁男性病例，该患者在接受常规剂量阿糖胞苷治疗急性髓系白血病期间，四肢逐渐出现无力和感觉丧失。出现症状后停用了阿糖胞苷，其运动和感觉功能在3个月内逐渐改善。
除了阿糖胞苷一些众所周知的副作用，包括骨髓抑制、小脑综合征和心脏毒性外，周围神经病变是阿糖胞苷不常见的副作用之一。诊断包括通过临床评估和神经传导研究来识别和分级化疗引起的周围神经病变（CIPN）的严重程度。管理措施包括停用化疗药物以及使用度洛西汀等药物进行支持治疗。最近的研究也支持使用针灸和基于感觉运动的运动干预来管理CIPN。
本病例报告是按照2023年SCARE标准编写的。
尽管罕见，但即使是常规剂量的阿糖胞苷也可导致周围神经病变，常规的神经肌肉检查有助于早期诊断和干预，以限制疾病的进一步进展并逆转病程。
