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Case Reports
. 2014 Sep;51(3):288-292.
doi: 10.4274/npa.y7059. Epub 2014 Sep 1.

Guillain-Barre Syndrome in a Patient with Primary Extranodal Intestinal Non-Hodgkin's Lymphoma: Paraneoplastic, Drug Induced or Coincidental?

Aslı Kiyat Atamer  1 , Kerem Okutur  2 , Erdem Tüzün  3 , Barış Hasbal  4 , Ari Boyaciyan  5 , Yakup Krespi  1 , Gökhan Demir  2
Affiliations
Case Reports

Guillain-Barre Syndrome in a Patient with Primary Extranodal Intestinal Non-Hodgkin's Lymphoma: Paraneoplastic, Drug Induced or Coincidental?

Aslı Kiyat Atamer et al. Noro Psikiyatr Ars. 2014 Sep.

Abstract
in English, Turkish

Neurological involvement is observed in 5%-25% of patients with lymphoma being either the first presentation of the disease or emerging during its course. However, Guillain-Barré syndrome is rarely reported. In this article, we present a case with intestinal lymphoma developing Guillain-Barré syndrome during the course of the disease. A 66-year-old male patient with primary extranodal intestinal lymphoma developed quadriparesis, sensory deficits and autonomic dysfunction while receiving chemotherapy. The findings of clinical, electrophysiological and laboratory examinations were consistent with Guillain-Barré syndrome. Guillain-Barré syndrome can potentially be fatal and mimic chemotherapy-induced neurotoxicity, especially in patients with lymphoma, and therefore, must be considered in the differential diagnosis.

Lenfomalı hastaların %5–%25’inde nörolojik tutulum gerek ilk klinik prezentasyon olarak, gerekse hastalık seyri sırasında gözlenebilir. Ancak Guillain Barré sendromu nadiren bidirilmiştir. Bu yazıda intestinal lenfoma seyrinde gelişen bir Guillain Barré sendromu olgusu sunulmuştur. Bilinen primer ekstranodal intestinal lenfoması olan ve kemoterapi alan 66 yaşında bir erkek hastada subakut kuadriparezi, duyu bozukluğu ve otonomik disfonksiyon gelişmiştir. Klinik muayene, elektrofizyolojik incelemeler ve laboratuar bulgularının Guillain-Barré sendromu ile uyumlu olduğu saptanmıştır. Guillain-Barré sendromu ölümcül bir hastalık olma potansiyeline sahiptir ve özellikle lenfoma hastalarında kullanılan kemoterapötik ajanların nörotoksik yan etkilerini taklit edebilir, bu nedenle ayırıcı tanıda gözetilmesi ve tedavisinin hızla başlatılması önemlidir.

Keywords: Guillain-Barré syndrome; lymphoma; neurotoxicity; paraneoplastic syndrome; vincristine.

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Conflict of interest statement

Conflict of interest: The authors reported no conflict of interest related to this article. Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir.

Figures

Figure 1A
Figure 1A
Tissue consisting of small intestine and cecum which form a conglomerate with the grey yellowish tumour. The cross-section shows that all layers of the intestines are fused with each other and that thickness of the intestinal wall reaches 4 cm in some areas
Figure 1B
Figure 1B
Immunhistochemical staining (x40): Tumour cells showing diffuse dissemination in the intestinal tissue. The atypical cells are large, pleomorphic and CD20 (+), with vesicular hyperchromatic nuclei having distinct nucleoli
See this image and copyright information in PMC

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