In this communication, we report an acute leukemia patient who
developed conversion disorder mimicking the adverse effects of
high-dose cytosine arabinoside (Ara-C) treatment after the patient
received high-dose Ara-C treatment.
A 21-year-old woman, with acute recurrent leukemia after bone marrow
transplantation, received high-dose Ara-C treatment and 10 days later
was referred for psychiatric consultation because of an abrupt onset of
convulsion. On neurologic examination, she showed convulsion of all the
limbs without loss of consciousness. All limbs looked paretic; however,
tendon reflexes in all limbs were normal and pathological reflex was
not recognized. When her hand was dropped onto her own face, it fell
next to her face but not on her face. Laboratory data were
unremarkable. She had no history of psychiatric illness or drug or
alcohol abuse.
The patient explained that she knew about the recurrence of her own
leukemia and the news of the death of a close friend due to leukemia at
the same time, which was a shocking event for her, focusing her
attention on her own fears of dying from the same disease.
Conversion disorder in cancer patients is not common; however,
appropriate diagnosis is very important to avoid inappropriate
examinations and treatments.
In leukemia patients receiving chemotherapy, various kinds of signs
and symptoms may develop due to the adverse effects of chemotherapy
and/or infection. Therefore, conversion disorder might be
overlooked and inappropriate treatment and examinations might be
performed. Clinicians should consider conversion disorder in the
differential diagnosis when patients develop unexplained neurological
symptoms.