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2', 3'-Dideoxycytidine (ddC) Toxic Neuropathy:A Study of 52 Patients
Neurol 43:358-362, Berger,A.R.,et al, 1993
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Article Abstract
We administered the antiviral agent 2',3'-dideoxycytidine(ddC)to HIV- infected patients with either ARC or AIDS as part of the AIDS Clinical Treatment Group protocol 012 and serially evaluated them with neuropathic symptom questionnaires,neurologic examinations,nerve conduction studies, and quantitative sensory testing(QST).All patients treated with high-dose ddC(0.06 and 0.03 mg/kg every 4 hours)developed a painful,predominantly sensory peripheral neuropathy,with a mean onset of 7.7 weeks,which reached severe intensity over several days.Abnormalities of vibration QST thresholds preceeded clinical symptoms.Treatment with 0.01 mg/kg every 4 hours produced a similar neuropathy,although of milder severity,later onset(mean,9.3 weeks),and slower progression.In these patients,the onset of clinical symptoms and QST abnormalities were coincident.Only two of six patients treated with 0.005 mg/kg every 4 hours developed clinical or laboratory evidence of neuropathy;in both cases it was very mild and delayed in onset(26 weeks).All patients treated with high-dose ddC reported progression of symptoms(coasting)for 2 to 3 weeks following discontinuation of therapy.This study documents a painful sensory neuropathy resulting from treatment with ddC.With high-dose treatments, only the rapidity of onset and progression differentiated it from the distal,predominantly sensory neuropathy of AIDS.
 
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adverse drug reaction
antiviral agents
burning feet
burning paresthesia
dideoxycytidine
hyporeflexia
iatrogenic neurologic disorders
neuropathy
neuropathy,iatrogenic
neuropathy,medication induced
neuropathy,painful
neuropathy,sensory
neuropathy,toxic
paresthesias
paresthesias,feet

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