: Acute acquired demyelinating polyneuropathy – an initial presentation of diffuse large B cell lymphoma

• Main Authors: Munira Shabbir- Moosajee, Ghulam Rehman Mohyuddin, Sara Khan, Ayeesha Kamal
• Format: Article
• Language: English
• Published: PAGEPress Publications 2014-08-01
• Series: Mediterranean Journal of Hematology and Infectious Diseases
• Subjects: Gullian Barre syndrome; diffuse large B cell lymphoma; initial presentation; intravenous immunoglobulin
• Online Access: https://mjhid.org/index.php/mjhid/article/view/1848

Neurological signs and symptoms are commonly associated with both Hodgkin’s and non-Hodgkin’s lymphoma.  This is most commonly due to either direct lymphomatous involvement of the nervous system either as a result of extension to the spinal cord or nerves or due to infiltration by lymphoma cells and drug toxicity. Gullian Barre syndrome and its variants have been reported very infrequently in the literature.  We present a case of a 70 year old who admitted to the hospital for evaluation of uncontrolled hypertension. Incidentally, he was noted to have a low platelet count and a leukoerythroblastic picture in the peripheral blood. Two days into admission, he developed bilateral symmetrical ascending paresis consistent with acute acquired demyelinating polyneuropathy - a common variant of Gullian barre syndrome (GBS). Around the same time he developed worsening cytopenias and was diagnosed with diffuse large B cell lymphoma on a bone marrow biopsy. He was treated with intravenous immunoglobulin for GBS with significant improvement of muscle strength and was subsequently treated with chemotherapy for the lymphoma.