A 2-year-old receiving Vincristine shows signs of peripheral neuropathy. Which symptoms may indicate this side effect?

• A. Constipation, altered gait
• B. Altered gait, diarrhea
• C. Vomiting, lack of sensation to heat/cold
• D. Lack of sensation to heat/cold, mucositis

Answer: (A)

Vincristine neurotoxicity often shows up as both motor and autonomic dysfunction. The motor nerves can be affected, leading to an altered gait from weakness or foot drop, while autonomic nerves can be damaged, causing constipation. Together, constipation and gait disturbance are the most characteristic signs of vincristine-induced peripheral neuropathy in young children. Diarrhea or vomiting are not typical features of this neuropathy, and mucositis is a separate mucosal effect, not neuropathic. Therefore, the pairing of constipation with an altered gait best indicates this side effect.