Acute Inflammatory Demyelinating Polyneuropathy and Bilateral Anterior Uveitis as the Presenting Manifestations of Hodgkin’s Lymphoma

Shirin  Assar; Mehran  Pournazari; Dena  Mohamadzadeh

doi:10.18502/crcp.v10i4.21111

Shirin Assar Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Mehran Pournazari Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Dena Mohamadzadeh Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

DOI: https://doi.org/10.18502/crcp.v10i4.21111

Keywords: Hodgkin’s lymphoma; Guillain-barré syndrome; Neuropathy; Uveitis

Abstract

Peripheral neuropathy is rarely the initial presentation of lymphoma. Acute inflammatory demyelinating sensorimotor neuropathy, meeting the diagnostic criteria of Guillain-Barré syndrome, might be associated with Hodgkin’s lymphoma. A 33-year- old woman presented with dyspnea, generalized lymphadenopathy, acute-onset progressive ascending muscle weakness of the lower extremities, and acute bilateral uveitis. EMG-NCV confirmed acute inflammatory demyelinating polyneuropathy. Malignant lymphoma was suspected. A core needle biopsy of the left axillary lymph node was performed and revealed the classic type of Hodgkin’s lymphoma. The ABVD regimen was administered along with five consecutive sessions of plasmapheresis. The neurological signs and symptoms improved gradually. In conclusion, acute inflammatory demyelinating polyneuropathy mimicking Guillain-Barré syndrome might be associated with HL and precede the diagnosis of lymphoma. Therefore, clinicians need to be aware of the neurological manifestations of lymphoma for appropriate diagnosis and treatment.