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Immune-mediated motor polyneuropathy after hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 40, pages 289–291 (2007)Cite this article

The peripheral neuropathies that develop after hematopoietic stem cell transplantation (HSCT) are very heterogeneous.1 Immune-mediated motor polyneuropathies including Guillain–Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) are rare but serious complications of HSCT, because they are characterized by potentially life-threatening motor deficits.1 Although both GBS and CIDP share many features, including flaccid paralysis, elevated CSF protein levels and electromyographic findings, they are considered separate clinical entities.2 Clinically, CIDP is distinguished from GBS by its course, which consists of a gradual progression over more than 2 months.2 Since the relevant literature has been almost exclusively limited to case reports, the clinical characteristics of GBS and CIDP after HSCT have yet to be elucidated.

The present patient showed characteristic features of GBS in the acute phase with rapid progression of symptoms over several days. She partially recovered within 2–4 months of initial treatment, although the degree of recovery was not sufficient. Repeated electromyographic findings also showed demyelinating changes. Since a sural nerve biopsy was not performed, the final diagnosis was ‘probable CIDP’. It has been reported that 2% of GBS patients are later diagnosed as having CIDP.3 GBS and CIDP differ not only in the duration of progression and prognosis but also in the response to treatment. Patients with CIDP often require further steroid or other immunosuppressive treatment in addition to IVIg or plasma exchange.

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References

  1. Openshaw H . Peripheral neuropathy after bone marrow transplantation. Biol Blood Marrow Transplant 1997; 3: 202–209.

    CAS  PubMed  Google Scholar 

  2. Hauser S, Asbury A . Guillain–Barré syndrome and other immune-mediated neuropathies. In: Kasper D (ed). Harrison's Principles of Internal Medicine, 16th edn. McGraw-Hill: New York, NY, 2005, pp 2513–2518.

    Google Scholar 

  3. Odaka M, Yuki N, Hirata K . Patients with chronic inflammatory demyelinating polyneuropathy initially diagnosed as Guillain–Barré syndrome. J Neurol 2003; 250: 913–916.

    Article  Google Scholar 

  4. Eliashiv S, Brenner T, Abramsky O, Shahin R, Agai E, Naparstek E et al. Acute inflammatory demyelinating polyneuropathy following bone marrow transplantation. Bone Marrow Transplant 1991; 8: 315–317.

    CAS  PubMed  Google Scholar 

  5. Wen PY, Alyea EP, Simon D, Herbst RS, Soiffer RJ, Antin JH . Guillain–Barré syndrome following allogeneic bone marrow transplantation. Neurology 1997; 49: 1711–1714.

    Article  CAS  Google Scholar 

  6. Rodriguez V, Kuehnle I, Heslop HE, Khan S, Krance RA . Guillain–Barré syndrome after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2002; 29: 515–517.

    Article  CAS  Google Scholar 

  7. Hernandez-Boluda JC, Lis MJ, Goterris R, Arbona C, Terol MJ, Tormo M et al. Guillain–Barré syndrome associated with cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 2005; 7: 93–96.

    Article  Google Scholar 

  8. Fujisaki G, Kami M, Murashige N, Kishi Y, Hori A, Chizuka A et al. Guillain–Barré syndrome associated with rapid immune reconstitution following allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2006; 37: 617–619.

    Article  CAS  Google Scholar 

  9. Amato AA, Barohn RJ, Sahenk Z, Tutschka PJ, Mendell JR . Polyneuropathy complicating bone marrow and solid organ transplantation. Neurology 1993; 43: 1513–1518.

    Article  CAS  Google Scholar 

  10. Matsumoto H, Seki N, Yamamoto T, Oshima K, Asai T, Motokura T et al. A case of asymmetric demyelinating neuropathy in a patient with chronic graft-versus-host disease. Rinsho Shinkeigaku 2005; 45: 748–753 (in Japanese).

    PubMed  Google Scholar 

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Acknowledgements

We thank the medical and nursing staffs of the Keio BMT Program.

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Authors and Affiliations

  1. Department of Neurology, Keio University School of Medicine, Tokyo, Japan

    S Suzuki & N Suzuki

  2. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    T Mori, A Mihara, Y Aisa, Y Ikeda & S Okamoto

  3. Novartis Pharma Program for Clinical Therapeutics of Hematologic Malignancy, Keio University School of Medicine, Tokyo, Japan

    T Mori

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  1. S Suzuki
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Correspondence to S Suzuki.

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Suzuki, S., Mori, T., Mihara, A. et al. Immune-mediated motor polyneuropathy after hematopoietic stem cell transplantation. Bone Marrow Transplant 40, 289–291 (2007). https://doi.org/10.1038/sj.bmt.1705716

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