Acute Polyneuropathy in Children with Acute Lymphocytic Leukemia: Case Report and Systemic Review of the Literature
Acute polyneuropathy in children with acute lymphoblastic leukemia is extremely
rare, but its onset and association with Guillain-Barré syndrome presents a diagnostic challenge.
We report a 5-year-old boy who presented with inability to walk during induction chemotherapy for acute lymphoblastic leukemia. Subsequently he developed painful penile erections, difficulty urinating and swallowing.
Besides adding a rare case to the literature and based on a systemic review of the literature, we provide and discuss the neurologic profile and differential diagnosis of the acute polyneuropathy in childhood leukemia.
Early recognition of acute polyneuropathy in children with acute lymphocytic leukemia will facilitate a judicious
use of immunotherapy for Guillain-Barré syndrome and prevent a high morbidly and mortality.
Acute Lymphoblastic Leukemia (ALL) peak age 2 to 5 years is the most common
(30%) form of all childhood malignancies. Central Nervous System (CNS) complications are
well documented in ALL.
Acute polyneuropathy before, during, and after the chemotherapy
has been documented in adults and children. However, it is a rare complication of ALL.
It is usually induced by vincristine or Guillain-Barre Syndrome (GBS). The clinical manifestation,
Cerebrospinal fluid (CSF), and neurophysiologic studies are the cornerstones in making the
diagnosis of acute polyneuropathy.
The chemotherapeutic drugs, vincristine, methotrexate and
cytarabine, and CNS radiation are essential components of ALL chemotherapy.
Neuro Open J. 2014; 1(1): 11-15. doi: 10.17140/NOJ-1-103