Navigating the chemotherapy-induced acute motor and sensory axonal neuropathy and diabetic ketoacidosis in an adolescent girl with acute lymphoblastic leukemia: A case report

Abstract

Acute lymphoblastic leukemia (ALL), the most common hematological malignancy of childhood, can cause significant morbidity and mortality due to the tumor burden or toxic effects of chemotherapeutic agents. Early detection and appropriate treatment of these complications are crucial for improving survival and quality of life. We report a case of a 12-year-old girl with B-cell ALL who experienced multiple chemotherapy-related adverse events, namely pancreatitis, hypertriglyceridemia, and a rare combination of steroid and l-asparaginase-induced hyperglycemia with diabetic ketoacidosis, and vincristine-induced acute motor and sensory axonal neuropathy. She was managed by discontinuation of vincristine and l-asparaginase and given intravenous immunoglobulin, fluid resuscitation, and antibiotics. She had a full neurological recovery within 2 months and continued with the modified chemotherapy protocol.