Guillain–Barré syndrome after allogeneic bone marrow transplantation: Case report and literature review

Tomoko Yoshida, MD; Yoshino Ueki, MD; Tomotaka Suzuki, MD; Yuichi Kawagashira, MD; Haruki Koike, MD; Shigeru Kusumoto, MD; Shinsuke Ida, MD; Takuya Oguri, MD; Masahiro Omura, MD; Sobue, MD; Noriyuki Matsukawa, MD

doi:10.1016/j.ensci.2016.08.001

eNeurologicalSci (Sep 2016)

Guillain–Barré syndrome after allogeneic bone marrow transplantation: Case report and literature review

Tomoko Yoshida, MD,
Yoshino Ueki, MD,
Tomotaka Suzuki, MD,
Yuichi Kawagashira, MD,
Haruki Koike, MD,
Shigeru Kusumoto, MD,
Shinsuke Ida, MD,
Takuya Oguri, MD,
Masahiro Omura, MD,
Sobue, MD,
Noriyuki Matsukawa, MD

Affiliations

Tomoko Yoshida, MD: Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Science, Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
Yoshino Ueki, MD: Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Science, Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
Tomotaka Suzuki, MD: Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Science, Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
Yuichi Kawagashira, MD: Department of Neurology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-Ku, Nagoya 466-8550, Japan
Haruki Koike, MD: Department of Neurology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-Ku, Nagoya 466-8550, Japan
Shigeru Kusumoto, MD: Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Science, Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
Shinsuke Ida, MD: Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Science, Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
Takuya Oguri, MD: Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Science, Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
Masahiro Omura, MD: Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Science, Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
Sobue, MD: Department of Neurology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-Ku, Nagoya 466-8550, Japan
Noriyuki Matsukawa, MD: Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Science, Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan

DOI: https://doi.org/10.1016/j.ensci.2016.08.001
Journal volume & issue: Vol. 4, no. C
pp. 52 – 55

Abstract

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A 50-year-old man with acute myelogenous leukemia underwent allogeneic bone-marrow transplantation (BMT). He presented with severe diarrhoea 86 days post BMT and was diagnosed with graft-versus-host disease (GVHD) based on skin and rectal biopsies. He complained of numbness and weakness in the distal extremities at 114 days after BMT. His symptoms rapidly deteriorated and he required mechanical ventilation for respiratory failure. His clinical course and the findings of a nerve conduction study fulfilled the criteria for diagnosis of Guillain–Barré syndrome (GBS). Sural nerve biopsy revealed active demyelination and infiltration of macrophages and CD8+ T-cells. After three cycles of intravenous immunoglobulin therapy, his symptoms gradually improved, and he could eventually walk unassisted. Although GBS has been known to develop after allogeneic BMT, the pathogenesis remains unclear, and specific treatment regimens have not been well established. Here, we report a case of GBS, caused by an immune-mediated mechanism related to GVHD, which was successfully treated using intravenous immunoglobulin therapy.

Published in eNeurologicalSci

ISSN: 2405-6502 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.journals.elsevier.com/eneurologicalsci/

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