A patient starts developing numbness and tingling in the fingertips and feet. There isn't much pain, but you do note some mild distal weakness. On exam, you can't really get deep tendon reflexes, not even an ankle jerk. Vibration perception is quite poor. On review of systems, the patient complains of colicky abdominal pain and constipation. You send the patient to nerve conduction studies and electromyography and find that there is a symmetric axonal neuropathy.
Challenge: What chemotherapeutic agent caused this?
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Chemo I
ReplyDeleteVincristine (which I’ve always assumed came from “wine of Christ”) is a vinca alkaloid that has antimicrotubule activity. Neurotoxicity and peripheral neuropathy is the main side effect.
Source: UpToDate.