Vincristine neurotoxicity with hyponatremia

Abstract

A case of childhood acute lymphatic leukemia is presented; the patient manifested abdominal distention, loss of deep tendon reflexes, seizures and coma without laboratory evidence of CNS leukemia; the patient also demonstrated hyponatremia and serum hypotonicity with simultaneous urinary hypertonicity. It is felt that this syndrome was a manifestation of vincristine toxicity. The neurotoxicity of vincristine is reviewed and it is suggested that inappropriate ADH secretion (IADHS) may reflect a direct neurotoxic effect of vincristine on the central nervous system sites of ADH formation and/or storage.