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題名 | Vincristine-induced Polyneuropathy=Vincristine導致多發性神經病變 |
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作者 | 賴冠銘; 王全正; 鐘智淵; 林炫聿; 張正雄; 林敬業; 沈銘鏡; 林正純; Lai, Guan-min; Wang, Ciyuan-jheng; Chung, Chih-yuan; Lin, Shyuann-yuh; Chang, Cheng-shyong; Lin, Chin-ye; Shen, Ming-ching; Lin, Jen-tsun; |
期刊 | 臺灣癌症醫學雜誌 |
出版日期 | 20120900 |
卷期 | 28:3 2012.09[民101.09] |
頁次 | 頁129-133 |
分類號 | 415.828 |
語文 | eng |
關鍵詞 | 顱神經病變; 多發性神經病變; Vincristine; Cranial neuropathy; Polyneuropathy; |
中文摘要 | 我們報告一個 55 歲的女性被診斷有瀰漫性大 B 細胞淋巴瘤併骨髓侵犯第四期。這名 女性一開始的表現是腹部飽脹,嚴重脾臟腫大,雙側腹股溝和頸部淋巴病變。左腹股溝 淋巴結病理切片為瀰漫性大 B 細胞淋巴瘤。她接受了標準的 R-CHOP 化療。左垂足和右 邊第六顱神經麻痺出現在第八次化療後。其他顱神經和周邊神經檢查結果是正常的。頭 部核磁共振和腦脊液檢查結果均正常。經由神經傳導檢查我們診斷為 vincristine 誘導的腦 神經和末梢神經病變。我們嘗試吡哆醇,吡啶斯的治療後病人主觀上覺得複視狀況改善。 然後喉返神經麻痺出現且在左垂足出現 8 週後她死於心跳呼吸驟停。 |
英文摘要 | We report the case of a 55-year-old woman who was diagnosed to have diffuse large B cell lymphoma with bone marrow involvement (stage IV). The patient presented with abdominal fullness, severe splenomegaly, and bilateral inguinal and cervical lymphadenopathy. Histopathological examination of the left inguinal lymph node confirmed the diagnosis of diffuse large B cell lymphoma, and a standard R-CHOP (rituximab, cyclophosphamide, epirubicin, vincristine, and prednisolone) chemotherapy regimen was initiated. After the eighth chemotherapy cycle, she developed left foot drop and right sixth cranial nerve palsy. The other cranial nerves and peripheral nerves were normal. Cranial magnetic resonance imaging and cerebrospinal fluid examination were normal. Vincristine-induced cranial and peripheral polyneuropathy was diagnosed via a nerve conduction velocity study. We commenced pyridoxine and pyridostigmine treatment, which led to a slight improvement in diplopia. However, the patient then developed laryngeal nerve palsy and died of sudden cardiopulmonary arrest 8 weeks after the initial presentation of left foot drop. |
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