PMID- 19110521
OWN - NLM
STAT- MEDLINE
DCOM- 20090630
LR  - 20131121
IS  - 0485-1439 (Print)
IS  - 0485-1439 (Linking)
VI  - 49
IP  - 12
DP  - 2008 Dec
TI  - [Asymmetric peripheral neuropathy following reduced-intensity cord blood 
      transplantation].
PG  - 1604-8
AB  - A 57-year-old male patient in the first remission of acute erythroid leukemia 
      underwent reduced-intensity umbilical cord blood transplantation. He developed 
      grade III acute graft-versus-host disease (GVHD) on day 29. Although the acute 
      GVHD was resolved with tacrolimus and steroid therapy, weakness developed in the 
      left upper extremity on day 59. Neurological examination demonstrated asymmetric 
      muscular weakness of the extremities with the proximal part of the left upper 
      extremity being markedly affected. Neurophysiological studies suggested that this 
      was due to immune-mediated demyelinating neuropathy. Intravenous immunoglobulin 
      (IVIG) therapy was administered at a dose of 0.4 g/kg/day for 5 days and 
      worsening of clinical symptoms ceased. While the patient developed diarrhea and 
      chronic GVHD of the skin and cytomegalovirus (CMV) antigenemia was repeatedly 
      positive, neurological exacerbation was stabilized. Neurological symptoms did not 
      immediately improve after the second and third dose of IVIG. Approximately 50 
      days after the third dose of IVIG, neurological symptoms improved with the 
      gradual resolution of diarrhea and CMV reactivation. Although the pathophysiology 
      of polyneuropathies after allo-SCT is not well understood, some reports suggest 
      an association with GVHD or alloreactive T cell expansion following antecedent 
      infection. This case provides valuable information regarding the pathophysiology 
      of peripheral neuropathy following allo-SCT.
FAU - Sumi, Masahiko
AU  - Sumi M
AD  - Department of Hematology, Nagano Red Cross Hospital, Japan.
FAU - Ichikawa, Naoaki
AU  - Ichikawa N
FAU - Sato, Shunichi
AU  - Sato S
FAU - Shimizu, Ikuo
AU  - Shimizu I
FAU - Yotsumoto, Mihoko
AU  - Yotsumoto M
FAU - Ueno, Mayumi
AU  - Ueno M
FAU - Kobayashi, Hikaru
AU  - Kobayashi H
LA  - jpn
PT  - Case Reports
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Rinsho Ketsueki
JT  - [Rinsho ketsueki] The Japanese journal of clinical hematology
JID - 2984782R
RN  - 0 (Immunoglobulins, Intravenous)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Acute Disease
MH  - Cord Blood Stem Cell Transplantation/*adverse effects
MH  - Graft vs Host Disease/drug therapy/etiology
MH  - Humans
MH  - Immunoglobulins, Intravenous/administration & dosage
MH  - Leukemia, Erythroblastic, Acute/therapy
MH  - Male
MH  - Middle Aged
MH  - Peripheral Nervous System Diseases/*etiology/therapy
MH  - T-Lymphocytes
MH  - Tacrolimus/therapeutic use
MH  - Transplantation Conditioning/*adverse effects
EDAT- 2008/12/27 09:00
MHDA- 2009/07/01 09:00
CRDT- 2008/12/27 09:00
PHST- 2008/12/27 09:00 [entrez]
PHST- 2008/12/27 09:00 [pubmed]
PHST- 2009/07/01 09:00 [medline]
AID - JST.JSTAGE/rinketsu/49.1604 [pii]
PST - ppublish
SO  - Rinsho Ketsueki. 2008 Dec;49(12):1604-8.