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
| Autor: | P.-F. Wey, C. Faulcon, H. Ghesquières, Petitjean F, A Drouet, P. Biron, L. Guilloton, Nicolas Virelizier E |
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| Rok vydání: | 2015 |
| Předmět: |
Pediatrics
medicine.medical_specialty Chemotherapy Guillain-Barre syndrome business.industry medicine.medical_treatment Context (language use) Hematopoietic stem cell transplantation Disease medicine.disease Surgery Immune system immune system diseases hemic and lymphatic diseases medicine Paralysis medicine.symptom Complication business |
| Zdroj: | Journal of Clinical Case Reports. |
| ISSN: | 2165-7920 |
| DOI: | 10.4172/2165-7920.1000508 |
| Popis: | Introduction: Guillain-Barre 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-Barre 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-Barre 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-Barre 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. |
| Databáze: | OpenAIRE |
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