African Journal of Internal Medicine
Vincristine-induced unilateral ptosis in a child with Wilms’ tumor
Sinan Akbayram1, Fesih Aktar2, Murat Doğan2, Cihangir Akgün2, Mustafa Izmirli3, Hüseyin Çaksen2, AhmetFaik Oner1
1Department of Pediatric Hematology, YuzuncuYil University Faculty of Medicine, Van, Turkiye.
2Department of Pediatrics, YuzuncuYil University Faculty of Medicine, Van, Turkiye.
3Department of Radiation Oncology, YuzuncuYilUniversity Faculty of Medicine, Van, Turkiye.
*Correspondingauthor E mail: firstname.lastname@example.org Tel. 0 +90- (505) 669 00 64
Accepted 27 June, 2013
This report describes the successful management of vincristine-induced unilateral ptosis with pyridoxine and pyridostigmine in a three year old girl with Stage 2a Wilms tumor. Vincristine as an antineoplastic drug causes neurotoxicity frequently. We report here about a 3-year-old girl having a vincristine-induced cranial polyneuropathy and a complete remission due to the therapy with pyridoxine and pyridostigmine. The 3-year-old girl was diagnosed with a Wilms tumor. Following nephroureterectomy she was treated with four cycles of actinomycin D (250 mg/m2), six cycles of adriamycine (20 mg/m2), six cycles of etoposide (100 mg/m2) and nine cycles of vincristine sulphate (1.4 mg/m2). One day after the last vincristine sulphate treatment, she developed unilateral ptosis without pupillary or other oculomotor dysfunction. A neuroprotective and neuroregenerative treatment of this vincristine-induced cranial neuropathy was attempted with pyridoxine (150 mg/m2/dayper oral bid) and pyridostigmine (3 mg/kg/dayper oral bid). The unilateral ptosis markedly improved after two weeks of pyridoxine and pyridostigmine treatment and completely resolved after 4 weeks.
Key words: Ptosis,vincristine sulphate, Wilms’ tumor, pyridoxine, pyridostigmine.