Peripheral neuropathy associated with angioimmunoblastic lymphadenopathy

Ferrer, Isidre; Vidaller, Antonio; Sevilla, Alberto Fernández de; Martı́nez-Matos, Juan Antonio; Montero, José María; Romagosa, V.

doi:10.1016/s0303-8467(88)80039-8

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…Peripheral neuropathy was suggested to represent an immune-mediated phenomenon in the affected patients. Ferrer et al [28] and Sonobe et al [29] each described patients with AILD/AILT and peripheral neuropathy wherein nerve biopsies showed histologic features suggestive of lymphomatous infiltration.…”

Section: Discussionmentioning

confidence: 99%

Angioimmunoblastic T Cell Lymphoma: An Unusual Presentation of Posttransplant Lymphoproliferative Disorder in a Pediatric Patient

2013

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Posttransplant lymphoproliferative disorders (PTLD) are a potentially life-threatening complication of immunosuppression in transplant recipients. The majority of cases are Epstein-Barr virus-associated lesions of B cell origin. T cell PTLD is rare, particularly in pediatric patients. We present an unusual case of monomorphic T cell PTLD with features of angioimmunoblastic T cell lymphoma in an 8-year-old heart transplant patient, presenting with cranial nerve palsy.

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Section: Discussionmentioning

confidence: 99%

Angioimmunoblastic T Cell Lymphoma: An Unusual Presentation of Posttransplant Lymphoproliferative Disorder in a Pediatric Patient

2013

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“…[8][9][10][11][12][13] The most frequent neurologic manifestations described in AITL are peripheral neuropathies. [14][15][16] In a recent series, eight of 77 patients (10%) presented neurologic symptoms at the time of AITL diagnosis, and two of them had tumor cells in the CSF. 9 In another series of 33 patients, one patient had CSF involvement.…”

Section: Discussionmentioning

confidence: 99%

Primary Cerebral Angioimmunoblastic T-Cell Lymphoma

Lachenal¹,

Berger

Cimarelli

et al. 2013

JCO

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A 71-year-old woman with a past medical history of chronic alcoholism and depression presented with a subacute confusional state and was admitted to the Department of Neurology (Hôpital Pierre Wertheimer, Bron, France) in November 2008. At admission, the patient was somnolent, apathetic, and confused. Her spatiotemporal orientation and cognitive function were impaired. She suffered from a moderately painful headache but presented no meningeal syndrome. An initial neurologic examination was performed, which did not reveal any focal abnormality or cranial nerve palsy. A general examination of the patient was normal except for weight loss and a low-grade fever (38.3°C), which disappeared in time. No peripheral lymphadenopathy, splenomegaly hepatomegaly, and/or rash were noted. The patient had a WHO performance status of 3. All laboratory tests results, including C-reactive protein levels, lactate dehydrogenase levels, and CBC, were normal. HIV testing was negative. A diagnosis of metabolic alcohol-or drug-related disorders was rejected.Brain computed tomography (CT) revealed extensive hypodensity in the right temporal lobe. Brain magnetic resonance imaging (MRI) revealed hyperintense lesions in the right temporal lobe on T2-weighted fluid-attenuated inversion recovery sequences ( Fig 1A) and diffusion-weighted sequences. After gadolinium injection, the signal was enhanced in the lesion periphery, which suggested the presence of mild edema (Fig 1B). MRI also D I A G N O S I S I N O N C O L O G Y

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“…1 Neuropathy has been reported in rare cases. 2 Moreover, most patients have a rapid course and systemic manifestations, including weight loss, high fevers, hepatosplenomegaly, and anemia, and the dysproteinemia is typically a polyclonal immunoglobulin elevation. 1 Castleman's disease, or angiofollicular lymph-node hyperplasia, is an atypical lymphoproliferative disorder that may be associated with lymphadenopathy.…”

Section: Causes Of Mononeuritis Multiplexmentioning

confidence: 99%

Case 9-2001

Gorson¹,

Hedley‐Whyte²,

Skinner³

2001

N Engl J Med

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A 64-year-old, right-handed woman was admitted to the hospital because of motor and sensory impairment in her right arm.Two years before admission, generalized lymphadenopathy had been diagnosed. At that time, the levels of urea nitrogen, creatinine, and calcium were normal. The hematocrit was 34.8 percent. Microscopical examination of a bone marrow specimen showed increased iron storage. Immunologic tests were performed (Table 1). Immunoelectrophoresis showed an IgG kappa monoclonal protein (1300 mg per deciliter). No Bence Jones protein was detected. A gallium scan showed no abnormalities. The angiotensin-converting enzyme level was normal. Repeated computed tomographic (CT) scans of the thorax showed a small, stable pulmonary nodule in the right upper lobe, with bilateral axillary, mediastinal, and left hilar lymphadenopathy. Biopsy specimens of axillary lymph nodes revealed proteinaceous lymphadenopathy. Immunophenotyping of a peripheral-blood specimen showed no evidence of a lymphoproliferative disorder.Eighteen months before admission, progressive weakness developed in the extensors of the fingers of the right hand. Thirteen months before admission, the sensation of a pinprick was slightly reduced in the fourth finger of the right hand and the second finger of the left hand and in the distribution of the right saphenous nerve. An electromyographic study was performed (Table 2).Ten months before admission, progression of the weakness in the right hand was noted, and the sensation of a pinprick was decreased over the palmar aspect of the right hand. Immunologic tests were performed (Table 1).Intravenous injections of immune globulin over a period of five days were ineffective. The impairment in the right arm worsened, and pain developed in the right wrist and metacarpophalangeal joints and in the left hand. Treatment with amitriptyline, nortriptyline, carisoprodol, and tramadol had intolerable side effects, and a six-day course of methylprednisolone, propoxyphene, and gabapentin did not relieve the pain.Five months before admission, an electromyographic study was performed ( Table 2). The erythrocyte sedimentation rate was 59 mm per hour. The levels of vitamin B 12 and thyrotropin were normal. Immunologic tests were performed (Table 1). Microscopical examination of a specimen from a right-sided sural-nerve biopsy showed no evidence of vasculitis.Two months before admission, the fingers of the left hand became increasingly sensitive, with progressive sensory loss. The patient had sustained a small, second-degree burn on a finger, without pain. Hoarseness developed, and examination showed paralysis of the left vocal cord. A CT study of the neck and chest was unchanged. The patient was referred to this hospital. *There was an IgG kappa M component at a moderate concentration. †GALOP denotes gait-disorder autoantibody, late-onset polyneuropathy.

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Peripheral neuropathy associated with angioimmunoblastic lymphadenopathy

Cited by 6 publications

References 7 publications

Angioimmunoblastic T Cell Lymphoma: An Unusual Presentation of Posttransplant Lymphoproliferative Disorder in a Pediatric Patient

Angioimmunoblastic T Cell Lymphoma: An Unusual Presentation of Posttransplant Lymphoproliferative Disorder in a Pediatric Patient

Primary Cerebral Angioimmunoblastic T-Cell Lymphoma

Case 9-2001

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