Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?

HASBAL, Barış; Tuzun, Erdem; BOYACIYAN, Ari; KRESPİ, Yakup; Demir, Gökhan; OKUTUR, Kerem; ATAMER KIYAT, Aslı

Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?

Aslı ATAMER KIYAT, (İstanbul Bilim Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Kerem OKUTUR, (Bilim Üniversitesi, Tıp Fakültesi, Onkoloji Anabilim Dalı, İstanbul, Türkiye)

Erdem TÜZÜN, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Deneysel Tıp Araştırma Enstitüsü, İstanbul, Türkiye)

Barış HASBAL, (İstanbul Bilim Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Ari BOYACIYAN, (Vehbi Koç Vakfı Amerikan Hastanesi, Nöroloji Bölümü, İstanbul, Türkiye)

Yakup KRESPİ, (Bezmialem Vakıf Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Gökhan DEMİR (Bilim Üniversitesi, Tıp Fakültesi, Onkoloji Anabilim Dalı, İstanbul, Türkiye)

Nöropsikiyatri Arşivi

1 0

Yıl: 2014 Cilt: 51 Sayı: 3 Sayfa Aralığı: 288 - 292 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?

Öz:

Lenfomalı hastaların %5-%25inde 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.

Anahtar Kelime:

Konular: Nörolojik Bilimler Psikiyatri

Primer ekstranodal intestinal lenfomalı bir hastada gözlenen guillain barré sendromu: paraneoplastik kökenli mi, ilaç yan etkisi mi, rastlantısal mı?

Öz:

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.

Anahtar Kelime:

Konular: Nörolojik Bilimler Psikiyatri

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık

1. Pritchard J, Hughes RA. Guillain-Barré syndrome. Lancet 2004; 363:2186-2188.
2. Vigliani MC, Magistrello M, Polo P, Mutani R, Chiò A; Piemonte and Valle dAosta Register for Guillain-Barré Syndrome. Risk of cancer in patients with Guillain-Barré syndrome (GBS): A population-based study. J Neurol 2004; 251:321-326.
3. Hughes RA, Britton T, Richards M. Effects of lymphoma on the peripheral nervous system. J R Soc Med 1994; 87:526-530.
4. Kelly JJ, Karcher DS. Lymphoma and peripheral neuropathy: a clinical review. Muscle Nerve 2005; 31:301-313.
5. Koike H, Tanaka F, Sobue G. Paraneoplastic neuropathy: wide-ranging clinicopathological manifestations. Curr Opin Neurol 2011; 24:504-510.
6. Pelosof LC, Gerber DE. Paraneoplastic syndromes: an approach to diagnosis and treatment. Mayo Clin Proc 2010; 85:838-854.
7. Machida H, Shinohara T, Hatakeyama N, Okano Y, Nakano M, Tobiume M, Naruse K, Iwahara Y, Ogushi F. CD-5 Positive Diffuse Large B Cell Lymphoma Infiltrating the Central Nervous System Presenting Guillain Barré Like Syndrome after Chemotherapy. J Clin Exp Hemathopathol 2012; 52:199-204.
8. Seffo F, Hamed A. Non-Hodgkin Lymphoma and Guillain-Barré Syndrome: A Rare Association. Clin Adv Hematol Oncol 2010; 8:201-203.
9. Bahl A, Chakrabarty B Gulati S, Raju KN, Raja A, Bakhshi S. Acute Onset Flaccid Quadriparesis in Pediatric Non-Hodgkin Lymphoma: Vincristine Induced or Guillain- Barré Syndrome? Pediatr Blood Cancer 2010; 55:1234-1235.
10. Terenghi F, Ardolina G, Nobile-Orazio E. Guillain-Barré syndrome after combined CHOP and rituximab therapy in non-Hodgkin lymphoma. J Peripher Nerv Syst 2007; 12:142-143.
11. Carmona A, Alonso JD, de las Heras M, Navarrete A. Guillain-Barré syndrome in a patient with diffuse large B-cell lymphoma, and rituximab maintenance therapy. An association beyond anecdotal evidence? Clin Transl Oncol 2006; 8:764-766.
12. Wanschitz J, Dichtl W, Budka H, Löscher WN, Boesch S. Acute motor and sensory axonal neuropathy in Burkitt-like lymphoma. Muscle Nerve 2006; 34:494-498.
13. Kivity S, Shalmon B, Sidi Y. Guillain-Barré syndrome: an unusual presentation of intravascular lymphoma. Isr Med Assoc J 2006; 8:137-138.
14. Magné N, Foa C, Castadot P, Otto J, Birtwisle-Peyrottes I, Thyss A. Guillain- Barré Syndrome and non-Hodgkins lymphoma. Report of one case and review of literature. Rev Med Brux 2005; 26:108-111.
15. Powers JF, Gross C. Guillain-Barré Syndrome in a Patient with Non-Hodgkins Lymphoma. Southern Medical Journal 2005; 98 Suppl: S24.
16. Naidech A, Weisberg L, Palliyath S, Kahn M. Sudden weakness in a patient with lymphoma. Cleve Clin J Med 2002; 69:337-341.
17. Rodriguez V, Kuehnle I, Heslop HE, Khan S, Krance RA. Guillain-Barré syndrome after allogenic hematopoietic stem cell transplantation. Bone Marrow Transplant 2002; 29:515-517.
18. Zuk E, Nowacki P, Fabian A. Guillain-Barré syndrome in a patient with Burkitts lymphoma and type 2 diabetes mellitus. Folia Neuropathol 2001; 39:281-284.
19. Re D, Schwenk A, Hegener P, Bamborschke S, Diehl V, Tesch H. Guillain-Barré syndrome in a patient with non-Hodgkins lymphoma. Ann Oncol 2000; 11:217-220.
20. Quasthoff S, Hartung HP. Chemotherapy-induced peripheral neuropathy. J Neurol 2002; 249:9-17.
21. González Pérez P, Serrano-Pozo A, Franco-Macías E, Montes-Latorre E, Gómez- Aranda F, Campos T. Vincristine-induced acute neurotoxicity versus Guillain-Barré syndrome: a diagnostic dilemma. Europ J Neurol 2007; 14:826-828.
22. Misra UK, Kalita J. Toxic Neuropathies. Neurol India 2009; 57:697-705.
23. Lewis RA. Chronic inflammatory demyelinating polyneuropathy and other immune- mediated demyelinating neuropathies. RA. Semin Neurol 2005; 25:217-228.
24. Barohn RJ, Saperstein DS. Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy. Semin Neurol 1998; 18:49-61.

APA	ATAMER KIYAT A, OKUTUR K, Tuzun E, HASBAL B, BOYACIYAN A, KRESPİ Y, Demir G (2014). Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. , 288 - 292.
Chicago	ATAMER KIYAT Aslı,OKUTUR Kerem,Tuzun Erdem,HASBAL Barış,BOYACIYAN Ari,KRESPİ Yakup,Demir Gökhan Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. (2014): 288 - 292.
MLA	ATAMER KIYAT Aslı,OKUTUR Kerem,Tuzun Erdem,HASBAL Barış,BOYACIYAN Ari,KRESPİ Yakup,Demir Gökhan Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. , 2014, ss.288 - 292.
AMA	ATAMER KIYAT A,OKUTUR K,Tuzun E,HASBAL B,BOYACIYAN A,KRESPİ Y,Demir G Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. . 2014; 288 - 292.
Vancouver	ATAMER KIYAT A,OKUTUR K,Tuzun E,HASBAL B,BOYACIYAN A,KRESPİ Y,Demir G Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. . 2014; 288 - 292.
IEEE	ATAMER KIYAT A,OKUTUR K,Tuzun E,HASBAL B,BOYACIYAN A,KRESPİ Y,Demir G "Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?." , ss.288 - 292, 2014.
ISNAD	ATAMER KIYAT, Aslı vd. "Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?". (2014), 288-292.

APA	ATAMER KIYAT A, OKUTUR K, Tuzun E, HASBAL B, BOYACIYAN A, KRESPİ Y, Demir G (2014). Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. Nöropsikiyatri Arşivi, 51(3), 288 - 292.
Chicago	ATAMER KIYAT Aslı,OKUTUR Kerem,Tuzun Erdem,HASBAL Barış,BOYACIYAN Ari,KRESPİ Yakup,Demir Gökhan Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. Nöropsikiyatri Arşivi 51, no.3 (2014): 288 - 292.
MLA	ATAMER KIYAT Aslı,OKUTUR Kerem,Tuzun Erdem,HASBAL Barış,BOYACIYAN Ari,KRESPİ Yakup,Demir Gökhan Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. Nöropsikiyatri Arşivi, vol.51, no.3, 2014, ss.288 - 292.
AMA	ATAMER KIYAT A,OKUTUR K,Tuzun E,HASBAL B,BOYACIYAN A,KRESPİ Y,Demir G Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. Nöropsikiyatri Arşivi. 2014; 51(3): 288 - 292.
Vancouver	ATAMER KIYAT A,OKUTUR K,Tuzun E,HASBAL B,BOYACIYAN A,KRESPİ Y,Demir G Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?. Nöropsikiyatri Arşivi. 2014; 51(3): 288 - 292.
IEEE	ATAMER KIYAT A,OKUTUR K,Tuzun E,HASBAL B,BOYACIYAN A,KRESPİ Y,Demir G "Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?." Nöropsikiyatri Arşivi, 51, ss.288 - 292, 2014.
ISNAD	ATAMER KIYAT, Aslı vd. "Guillain-barre syndrome in a patient with primary extranodal ıntestinal non-hodgkin's lymphoma: paraneoplastic, drug induced or coincidental?". Nöropsikiyatri Arşivi 51/3 (2014), 288-292.