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Case Reports in Hematology
Volume 2015 (2015), Article ID 979237, 4 pages
http://dx.doi.org/10.1155/2015/979237
Case Report

Variant Guillain-Barré Syndrome in a Patient with Non-Hodgkin’s Lymphoma

1St George Hospital, Kogarah, Sydney, NSW 2217, Australia
2Shoalhaven District Memorial Hospital, Nowra, NSW 2541, Australia
3Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia

Received 18 March 2015; Revised 5 July 2015; Accepted 3 August 2015

Academic Editor: Kostas Konstantopoulos

Copyright © 2015 R. H. Bishay et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report a 72-year-old female patient with diffuse large B cell non-Hodgkin’s lymphoma (NHL) with previous treatment with standard chemotherapy presenting as an acute, ascending, sensorimotor polyneuropathy. Nerve conduction studies and lumbar puncture supported a rare, but ominous, axonal variant of Guillain-Barré Syndrome (GBS) known as acute motor and sensory axonal neuropathy (AMSAN), which is distinguished from the more common, acute demyelinating forms of GBS. Previous reports have largely focused on toxicities secondary to chemo- or radiotherapy as a major contributor to the development of acute neuropathies in malignancy. Clinicians should also be mindful of direct neoplastic invasion or, less commonly, paraneoplastic phenomenon, as alternative mechanisms, the latter possibly reflecting immune dysregulation in particularly aggressive lymphomas. At the time of writing, this is the first report in the literature of an axonal variant of GBS in a patient with diffuse large B cell NHL. A discussion regarding common and uncommon neuropathies in haematological malignancies is made, with a brief review of the anecdotal evidence supporting a paraneoplastic association with GBS or its variant forms in the setting of lymphoma.