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累及周围神经系统并伴有抗GM1和GD1b IgM抗体的弥漫性大B细胞淋巴瘤:一例报告

Diffuse large B-cell lymphoma involving peripheral nervous system with IgM antibodies against GM1 and GD1b: A case report.

作者信息

Jiang Zhaocai, Ju Weina, Luo Shen, Yang Yu

机构信息

Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin, China.

出版信息

Medicine (Baltimore). 2019 Apr;98(15):e15049. doi: 10.1097/MD.0000000000015049.

Abstract

RATIONALE

The occurrence of peripheral neuropathy associated with non-Hodgkin's lymphoma (NHL) is uncommon. And autoimmunity may play an important role. We report a case of the patient with NHL, has sensorimotor demyelinating polyneuropathy.

PATIENT CONCERNS

The patient presented with a 1-month history of progressive numbness at the distal extremities and motor weakness of the lower limbs. Meanwhile, patient also endorsed a painful lump on her right cheek. And then the enlarged cervical and supra clavicular lymph nodes were observed on admission. Biopsy of the lymph nodes showed NHL. Serum IgM antibodies against GM1 and GD1b were also positive.

DIAGNOSIS

Biopsy of the lymph nodes showed NHL. Serum IgM antibodies against GM1 and GD1b were also positive. Thus, the patience was diagnosed with lymphoma and sensorimotor polyneuropathy.

INTERVENTIONS

Patient refused the further treatment.

OUTCOMES

After 11-month follow-up, the weakness of bilateral lower limbs worsens.

LESSONS

We have presented a case of NHL involving peripheral polyneuropathy with IgM antibodies against GM1 and GD1b. Patients may initially present with peripheral nerve complications or develop them during the course of lymphoma, even when in remission. This could complicate the diagnosis of peripheral polyneuropathy secondary to NHL.

摘要

理论依据

与非霍奇金淋巴瘤(NHL)相关的周围神经病变并不常见。自身免疫可能起重要作用。我们报告一例患有NHL且伴有感觉运动性脱髓鞘性多发性神经病的患者。

患者情况

患者有1个月渐进性远端肢体麻木及下肢肌无力病史。同时,患者还称右脸颊有一疼痛性肿块。入院时发现颈部及锁骨上淋巴结肿大。淋巴结活检显示为NHL。血清抗GM1和GD1b IgM抗体也呈阳性。

诊断

淋巴结活检显示为NHL。血清抗GM1和GD1b IgM抗体也呈阳性。因此,该患者被诊断为淋巴瘤及感觉运动性多发性神经病。

干预措施

患者拒绝进一步治疗。

结果

经过11个月的随访,双下肢无力加重。

经验教训

我们报告了一例伴有抗GM1和GD1b IgM抗体的NHL累及周围多发性神经病的病例。患者最初可能表现为周围神经并发症,或在淋巴瘤病程中出现,即使处于缓解期。这可能会使继发于NHL的周围多发性神经病的诊断复杂化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4368/6485863/c5013cc4ae22/medi-98-e15049-g002.jpg

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