alphabetical order

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i did a search and found this and it says this person only had a total of 4

mg of this drug. yet persons with cmt who drinks a lot or a little but for a

long time and don't have this kind of reaction that is long term and from

what i understand with drinking that if you stop your symptoms get better so

i think its just listed by alphabetical order. not by how severe it affects

you.

Acute deterioration of Charcot-Marie-Tooth disease IA (CMT IA) following 2

mg of vincristine chemotherapy.

Hildebrandt G, Holler E, Woenkhaus M, Quarch G, Reichle A, Schalke B,

Andreesen R.

Department of Hematology & Oncology, University of Regensburg, Germany.

gerhard.hildebrandt@...

BACKGROUND: Severe up to life-threatening neuropathy has been observed in

patients with hereditary neuropathies receiving vincristine. CASE REPORT: A

52-year-old female painter suffering from high-grade non-Hodgkin's lymphoma

(stage IVB) was treated with a total of 4 mg of vincristine during two

courses of CHOP chemotherapy (cyclophosphamide, vincristine, adriamycin,

prednisone). At onset of treatment no neurological problems were reported.

There was good lymphoma response to chemotherapy. At the same time, however,

the patient gradually developed dysphagia, dysarthria, muscular weakness of

both lower and upper extremities, areflexia, paraesthesia of the fingertips

and bilateral sensory impairment of feet and lower legs. These symptoms

continually worsened over a period of seven weeks until she was unable to

walk or to perform her work. Electrophysiological studies showed peripheral

axonal and demyelinative sensorimotor neuropathy in correlation to

histological findings. Molecular analysis revealed 17p11.2 duplication

typical for Charcot-Marie-Tooth disease IA. While continuing chemotherapy

without the use of vincristine the patient's neurologic symptoms slowly

recovered within six months. CONCLUSION: Prior to administration of

vincristine family and patient history as well as physical examination

should be performed carefully to look for underlying hereditary neuropathy.

For those patients with a clinical history or symptoms suggestive for CMT

nerve conduction velocity studies and on an individual base even molecular

genetic analysis are necessary to prevent serious neurologic complications.

worsened significantly resulting in dependency on a wheelchair and inability

to perform her work as a painter. Finally she consulted a neurologist and

was admitted to hospital for further diagnostic studies and continuation of

treatment for her lymphoma in March 1998 with a provisional diagnosis of

severe vincristine-induced neuropathy. Medical history at time of admission

included hyperthyroidism, that was currently treated with propylthiouracil,

a MALT lymphoma 1983, that was treated surgically only, and a

meningoencephalitis in 1968. No further medication was taken. In addition

she had a history of Lyme disease since 1993 with positive IgM-titer until

December 1997, when antibiotic therapy with doxycycline and ceftriaxone was

administered successfully. Family history obtained on admission revealed

that her mother had non-specific neuropathic symptoms as well as a poorly

defined foot deformities of the mother's father. The patient's brother does

not show any neurologic impairment and is in good physical health.

http://www.ncbi.nlm.hih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

0942065 & dopt=Abstract

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