Guillain-Barre syndrome in a patient with non-Hodgkin's lymphoma

We describe a case of Guillain-Barre syndrome (GBS) in a patient with non-H odgkin's lymphoma (NHL). A 21-year-old woman with a newly diagnosed stage I V high-grade lymphoma (precursor T-cell NHL according to the R.E.A.L. Class ification) developed flaccid quadriparesis and bilateral facial diplegia af ter three weeks of treatment with vincristine, daunorubicin, L-asparaginase and prednisolone. The clinical course and neurological examination were co nsistent with GBS. Despite treatment with intravenous immunoglobulins her n eurological symptoms progressed. Plasmapheresis was therefore initiated fol lowed by intravenous immunoglobulins. After partial remission of neurologic symptoms, induction chemotherapy with cyclophosphamide and cytarabine was continued without any further complication. Three months later, the lymphom a was in complete remission. GBS has been described in Hodgkin's disease an d after bone marrow transplantation but is rare in NHL. In patients with NH L who develop neurological symptoms, drug toxicity and nervous system infil tration are the leading cause of neuropathology, but GBS should be consider ed in the differential diagnosis.