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Case Report
Favorable response to cyclophosphamide in a patient with refractory Guillain–Barre syndrome associated with chronic lymphocytic leukemia
1 Haematology Department, University Hospital Southampton, Southampton, UK
2 Neurology Department, University Hospital Southampton, Southampton, UK
3 Intensive Care Department, University Hospital Southampton, Southampton, UK
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Nicholas Lafferty
Haematology Department, Southampton General Hospital, Southampton, SO16 6YD,
UK
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Article ID: 101286Z01NL2022
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Lafferty N, Sehgal T, Duncombe A, Katifi H, Allen D, Karar S. Favorable response to cyclophosphamide in a patient with refractory Guillain–Barre syndrome associated with chronic lymphocytic leukemia. Int J Case Rep Images 2022;13:101286Z01NL2022.ABSTRACT
Introduction: Neurological symptoms may occur in patients with chronic lymphocytic leukemia (CLL) through a variety of etiologies. However, autoimmune disorders involving the nervous system, such as Guillain–Barre syndrome (GBS), have only rarely been reported in patients with CLL, despite the well-established association between CLL and other autoimmune phenomena. Previous reports demonstrate no consistent approach to management of these cases.
Case Report: Here we report a case of severe GBS associated with newly diagnosed CLL. The patient did not respond to initial therapy with intravenous immunoglobulin, plasmapheresis, and corticosteroids, but demonstrated a rapid neurological and hematological improvement following cyclophosphamide infusion.
Conclusion: Here, for the first time, we describe the successful treatment of CLL-associated GBS using cyclophosphamide.
Keywords: B cell, Chronic, Cyclophosphamide, Guillain–Barre syndrome, Leukemia, Lymphocytic
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Author Contributions
Nicholas Lafferty - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Tushar Sehgal - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Andrew Duncombe - Acquisition of data, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Haider Katifi - Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
David Allen - Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Shoura Karar - Acquisition of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Nicholas Lafferty et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
