Guillain-Barre Syndrome Associated with Rapid Immune Reconstitution Following a Tandem Autologous Hematopoietic Stem Cell Transplantation. Study of a Case and Review of the Literature
|Guilloton L1*, Wey PF2, Faulcon C2, Ghesquières H3, Petitjean F2, Nicolas Virelizier E3, A Drouet1 and Biron P3|
|1Department of Neurology, HIA Desgenettes 108 Boulevard Pinel 69275 Lyon cedex 03, France|
|2Department of Resuscitation, HIA Desgenettes 108 Boulevard Pinel 69275 Lyon cedex 03, France|
|3Department of Oncology, Centre Léon Bérard, 28 rue Laennec, 69373 Lyon cedex 08, France|
|Corresponding Author :||Guilloton L
Department of Neurology, HIA Desgenettes
108 Bd Pinel 69275 Lyon Cedex 03, France
E-mail: [email protected]
|Received March 05, 2015; Accepted March 29, 2015; Published March 31, 2015|
|Citation: Guilloton L, Wey PF, Faulcon C, Ghesquières H, Petitjean F, et al. (2015) Guillain-Barre Syndrome Associated with Rapid Immune Reconstitution Following a Tandem Autologous Hematopoietic Stem Cell Transplantation. Study of a Case and Review of the Literature. J Clin Case Rep 5:508. doi:10.4172/2165-7920.1000508|
|Copyright: © 2015 Guilloton L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Introduction: Guillain-Barré syndrome (GBS) is a frequent cause of neuromuscular paralysis and usually occurs after an immunoallergic reaction, most often after respiratory or gastrointestinal infection. However, rare cases of Guillain-Barré syndrome are described, associated with hematopoietic stem cell transplantation.
Observation: Patient n° 20452690. The authors report the case of 21 years old man, treated for Hodgkin lymphoma with a recurrence at 18 months, who enjoyed second autologous hematopoietic stem cell transplantation after conditioning chemotherapy, then developed a Guillain-Barré syndrome. Plasma exchanges were made before a neurological worsening. Thereafter, five cycles of intravenous immunoglobulin were performed monthly. Unfortunately this development was hampered by mechanical respiratory complication that led to the death of the patient, the 237th day of evolution. The final diagnosis of Guillain-Barré syndrome, occurred in a context of post-transplant immune reconstitution in a patient treated for Hodgkin lymphoma was retained.
Discussion: GBS is a rare complication of hematopoietic stem cell transplantation. After literature review, we collected 33 cases related to this disease, 10 occurred after autograft. Etiopathogenic mechanisms remain obscure. Despite the use of immunomodulatory treatment, the prognosis is often severe and dark.
Conclusion: GBS is possible after autologous hematopoietic stem cell transplantation indicated for the treatment of Hodgkin lymphoma. The initial clinical severity, despite safeguards and use of immunomodulatory therapy, will cause often deleterious and poor outcome. To our knowledge, this well documented observation is the first case indicated for Hodgkin lymphoma.