Neumann Y, Toren A, Rechavi G, Seifried B, Shoham N G, Mandel M, Kenet G, Sharon N, Sadeh M, Navon R
Institute of Hematology, Chain Sheba Medical Center, Tel-Hashomer, Israel.
Med Pediatr Oncol. 1996 Apr;26(4):280-3. doi: 10.1002/(SICI)1096-911X(199604)26:4<280::AID-MPO12>3.0.CO;2-J.
A 16-year-old male suffering from Ewing's sarcoma of the pelvis was treated with vincristine as part of his chemotherapeutic protocol. The boy was never known to suffer from any neurological problems. His father had a mild limp, attributed to prolonged "taxi driving," that was never investigated medically. The first course of treatment, which included 2 mg of vincristine, resulted in clinical improvement. However, at the same time the patient developed severe weakness of both upper and lower limbs, areflexia, and gradually a pes cavus deformity. Nerve conduction studies were suggestive of severe peripheral sensorimotor neuropathy, axonal and demyelinative. A definite diagnosis of Charcot-Marie-Tooth was confirmed by molecular analysis showing the typical duplication of 1.5 megabases at 17 p11.2. This unique manifestation of vincristine neurotoxicity is reported and discussed.
一名16岁患有骨盆尤因肉瘤的男性患者，在其化疗方案中接受了长春新碱治疗。该男孩此前从未有过任何神经问题。他的父亲有轻微跛行，归因于长期“出租车驾驶”，但从未进行过医学检查。第一个疗程包括2毫克长春新碱，治疗后临床症状有所改善。然而，与此同时，患者出现了双上肢和双下肢严重无力、腱反射消失，并逐渐出现高弓足畸形。神经传导研究提示严重的周围感觉运动神经病变，呈轴索性和脱髓鞘性。分子分析显示在17 p11.2处有典型的1.5兆碱基重复，从而确诊为夏科-马里-图斯病。本文报告并讨论了长春新碱神经毒性的这一独特表现。
