Fulminant peripheral neuropathy with severe quadriparesis associated with vincristine therapy

OBJECTIVE: To report a case of fulminant neuropathy with severe quadriparesis associated with vincristine chemotherapy. CASE SUMMARY: 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. DISCUSSION: Although commonly associated with peripheral neuropathy, vincristine neurotoxicity only rarely involves instances of fulminant peripheral neuropathy with severe quadriparesis. Guillain-Barre syndrome is also associated with leukemia and may present as a fulminant peripheral neuropathy with severe quadriparesis. CONCLUSIONS: 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-Barre syndrome than to vincristine neurotoxicity.

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				A. M. Orejana-Garcia, J. Pascual-Huerta, and A. Perez-Melero Charcot-Marie-Tooth Disease and Vincristine J Am Podiatr Med Assoc, May 1, 2003; 93(3): 229 - 233. [Abstract] [Full Text] [PDF]