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Indian Journal of Hematology and Blood Transfusion
Published in: Indian Journal of Hematology and Blood Transfusion 1/2016

01-06-2016 | Case Report

Clinical Presentation of Inadvertent Intrathecal Vincristine Masquerading Guillain–Barre Syndrome

Authors: Agni Sekhar Saha, Md. Fekarul Islam, Sukanta Bhattacharya, Prabhas Prasun Giri

Published in: Indian Journal of Hematology and Blood Transfusion | Special Issue 1/2016

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Abstract

Vincristine, a potent chemotherapeutic agent, is highly neurotoxic. If given intrathecally by accident it is almost always fatal. We are reporting a 6 year old girl with acute lymphoblastic leukaemia in complete remission, who was given inadvertent intrathecal Vincristine instead of Methotrexate. She developed gradually progressive quadriplegia and respiratory paralysis requiring prolonged mechanical ventilation, initially mimicking Guillain–Barre Syndrome, both clinically and electro-physiologically. She also developed progressive encephalopathy. The clinical deterioration subsequently plateaued without any significant improvement and after more than 5 months, she finally expired.
Literature
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Lagman JL, Tigue CC, Trifilio SM, Belknap S, Buffie CG, Bennett CL (2007) Inadvertent intrathecal administration of vincristine. Community Oncol 4:45–46CrossRef
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Gomber S, Dewan P, Chhonker D (2010) Vincristine induced neurotoxicity in cancer patients. Indian J Pediatr 77(1):97–100CrossRefPubMed
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Alcaraz A, Rey C, Concha A, Medina A (2002) Intrathecal vincristine: fatal myeloencephalopathy despite cerebrospinal fluid perfusion. J Toxicol Clin Toxicol 40:557–561CrossRefPubMed
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Qweider M, Gilsbach JM, Rohde V (2007) Inadvertent intrathecal vincristine administration: a neurosurgical emergency. Case report. J Neurosurg Spine 6(3):280–283CrossRefPubMed
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Schulmeister Lisa (2006) Preventing vincristine administration errors: does evidence support minibag infusions? Clin J Oncol Nurs 10(2):271–273CrossRefPubMed
Metadata
Title
Clinical Presentation of Inadvertent Intrathecal Vincristine Masquerading Guillain–Barre Syndrome
Authors
Agni Sekhar Saha
Md. Fekarul Islam
Sukanta Bhattacharya
Prabhas Prasun Giri
Publication date
01-06-2016
Publisher
Springer India
Published in
Indian Journal of Hematology and Blood Transfusion / Issue Special Issue 1/2016
Print ISSN: 0971-4502
Electronic ISSN: 0974-0449
DOI
https://doi.org/10.1007/s12288-016-0666-y

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