Combined therapy of telbivudine and pegylated interferon α-2a induced sensory neuropathy:2 case reports / 中华神经科杂志

Objective To report the clinical and pathological features of the sensory neuropathy caused by a combined therapy of telbivudine and pegylated interferon α-2a in 2 patients with hepatitis B virus infection Methods Two male patients aged 48(case 1)and 20(case 2),who suffered from hepatitis B virus infection.were given telbivudine and pegylated interferon α-2a.After 4 months treatment,both patients developed numbness and pain in the lower limbs.The physical examination showed decreased pain sensation in distal extremities.Hypahidrosis appeared in distal extremities.The nails were pale changed in fingers and toes in cage 1.Case 2 presented mild weakness in the proximal muscle of lower limbs and the tendon reflex was decreased in both lower limbs.His 8erunl creatine kinase level was mild elevated.The electromyography examination and sural nerve biopsies were performed on both patients.Results Electromyography examination showed significant decrease of amplitude of sensory nerve action potentials and mild decrease of sensory nerve conduction velocities in both patients.The amplitude of motor nerve action potentials was also decreased in case 2.Light microscope examination revealed middle reduction of myelinated fibers,wallerian degeneration of myelinated fibers and small clusbers of regenerated fibers in sural nerve.Electro microscopy examination revealed the loss of unmyehnated nerve fibers.After the combined therapy was stopped and vitamin B,CoQ10 and L-camitine were administered,the patients recovered gradually.Conclusions Combined therapy of telbivudine and pegylated interferon α-2a may cause sensory neuropathy with electrophsiological and pathological abnormalities of axonal lesions.The sensory neuropathy induced by the combined therapy may be reversible.

CLINICAL ANALYSIS OF 71 CASES WITH ADENOSQUAMOUS CARCINOMA OF LUNG / 解放军医学杂志

Adenosquamous lung carcinoma(ASLC) was a rare pathologic type of the lung cancer. In order to improve the levels of the diagnosis and the treatment of ASLC,we analysed the clinical features of 71 cases of ASLC in our hospital from January 1993 to January 2000 retrospectively. The results showed that there was an evidence of young age in its occurrence.The majority of this type of cancer was located peripherally. It occurred most frequently in the posterior segments of the upper lobes and superior segments of the lower lobes. The biopsy obtained by surgery was the most reliable diagnostic way for the determination of pathologic type. The prognosis was poor. The five year survival rate after surgical operation was 12.2%. Early diagnosis may be made in routine general check up. An early diagnosis and surgical treatment could prolong surviving time of the patients.