Toksične polineuropatije

master's thesis

• Title (english): Toxic polyneuropathies
• Author: Željka Ćuk
• Mentor: Ervina Bilić (mentor)
• Committee member: Marija Žagar (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Ervina Bilić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Toksična polineuropatija je oštećenje perifernih živaca uzrokovano štetnim djelovanjem tvari koje se unose u organizam, najčešće su to lijekovi ali toksična neuropatija može biti uzrokovana i drugim tvarima iz okoliša bolesnika. Lijekovi, osobito oni koji se koriste u liječenju malignih bolesti, daleko su najčešći uzročnici toksične polineuropatije. Najčešći citotoksični lijekovi koji uzrokuju citostaticima uzrokovanu neuropatiju (CUN, engl. chemotherapy induced peripheral neuropathy (CIPN)) su spojevi platine, vinka alkaloidi, bortezomib i talidomid. Toksična neuropatija je česta nuspojava navedenih lijekova i može biti limitirajući čimbenik u primjeni citostatika. Neurotoksičnost lijekova je ovisna o kumulativnoj dozi lijeka. CUN se razvija postupno, tijekom tjedana ili mjeseci nakon početka liječenja citostaticima, a težina neuropatije ovisi o duljini trajanja primjene neurotoksičnog lijeka i ukupnoj dozi lijeka. Toksične neuropatije uzrokovane lijekovima ( DIP, engl. drug induced peripheral neuropathy) su pretežito senzorne ili senzomotorne i često udružene s pozitivnim osjetnim simptomima odnosno s boli. Osjetni i motorički deficit su najčešće posljedica oštećenja debelih vlakana perifernih živaca dok su pozitivni osjetni simptomi, posebice neuropatska bol, posljedica oštećenja tankih vlakana odnosno neuropatije tankih vlakana. Dijagnoza toksične neuropatije se temelji prvenstveno na anamnestičkim podacima, kliničkim i elektrofiziološkim nalazima. U većine bolesnika dolazi do povlačenja simptoma (boli i parestezija) nakon prestanka uzimanja citostatika. Međutim, u nekih bolesnika toksična neuropatija je djelomično
reverzibilna ili čak trajna. Trenutno nema lijeka koji bi mogao potpuno prevenirati ili liječiti CUN.

Abstract (english)

Toxic polyneuropathy is damage of peripheral nerves caused by the deleterious effects of substances introduced into the body, most often drugs but toxic neuropathy can be caused by other substances from the environment of the patient. Drugs, particularly those used in the treatment of malignant disease, by far the most common causes of toxic polyneuropathy. The most common cytotoxic drugs causing chemotherapy induced neuropathy (CIPN, engl chemotherapy induced peripheral neuropathy) are platinum compounds, vinca alkaloids, bortezomib and thalidomide. Toxic neuropathy is a common side effect of these drugs can be a limiting factor in the application of cytostatics. Neurotoxicity of drugs is usually dependent on cumulative dose of drug. CUN develops gradually, over weeks or months after initiation of treatment with cytostatics, and the severity of neuropathy depend on the duration of application of neurotoxic drug and total dose of the drug. Toxic neuropathies induced by drug (DIPN, engl. drug induced peripheral neuropathy) are predominantly sensory or sensorimotor and often associated with positive sensory symptoms and pain. Sensory and motor deficits are usually a result of damaging small fibers while positive sensory symptoms, particularly neuropathic pain, the result of damaging the small fibers or small fiber neuropathy. Diagnosis of toxic neuropathy is based primarily on history taking, clinical and electrophysiological findings. In most patients, symtomps (pain and paraesthesia) completely resolve after cessation of treatment. However, in some patients, toxic
neuropathy is only partially reversible and can be permanent. Up to now, no drug is available to reliably prevent or cure CIPN.

• Keywords: toksična neuropatija; kemoterapijom inducirana neuropatija; neurotoksičnost
• Keywords (english): toxic neuropathy; chemotherapy induced neuropathy; neurotoxicity
• Language: croatian
• URN:NBN: urn:nbn:hr:105:948335
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-05 14:44:44