A severe case of neuroleukemiosis caused by B cell chronic lymphocytic leukemia, presenting as mononeuritis multiplex

Aims To report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex. Methods The patient underwent extensive evaluation, including nerve conduction study and myography, brain and plexus MRI, and nerve biopsy. Results The cli...

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Published in:	Journal of the peripheral nervous system Vol. 28; no. 2; pp. 266 - 268
Main Authors:	Vicino, Alex, Cochet, Stéphane, Pistocchi, Silvia, Conrad, Curdin, Ribi, Camillo, Du Pasquier, Renaud, Brouland, Jean‐Philippe, Théaudin, Marie
Format:	Journal Article
Language:	English
Published:	Malden, USA Wiley Periodicals, Inc 01.06.2023 Wiley Subscription Services, Inc
Subjects:	Biopsy Biopsy - adverse effects Chemotherapy Chronic lymphocytic leukemia chronic lymphoid leukemia Cryoglobulinemia Diagnosis Humans Leukemia, Lymphocytic, Chronic, B-Cell - complications Lymphatic leukemia Magnetic Resonance Imaging mononeuritis multiplex Mononeuropathies - diagnosis Mononeuropathies - drug therapy Mononeuropathies - etiology Nerve conduction Nerve Conduction Studies neuroleukemiosis neurolymphomatosis Patients neuroleukemiosis chronic lymphoid leukemia neurolymphomatosis mononeuritis multiplex
ISSN:	1085-9489, 1529-8027, 1529-8027
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Abstract	Aims To report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex. Methods The patient underwent extensive evaluation, including nerve conduction study and myography, brain and plexus MRI, and nerve biopsy. Results The clinical and electrophysiological diagnosis was a mononeuritis multiplex with severe motor and sensory involvement; only the nerve biopsy allowed definite diagnosis and introduction of chemotherapy, leading to resolution of sensory deficit and progressive motor improvement. Discussion Neuroleukemiosis caused by chronic lymphoid leukemia is an exceptional diagnosis. The presence of other possible causes like cryoglobulinemia could induce avoidance of nerve biopsy thus undertreating patient, since steroid treatment is not expected to be efficient on lymphocytic proliferation. Our case stretches the importance of nerve biopsy and raises neuromuscular specialist's awareness of this rare entity.
AbstractList	AimsTo report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex.MethodsThe patient underwent extensive evaluation, including nerve conduction study and myography, brain and plexus MRI, and nerve biopsy.ResultsThe clinical and electrophysiological diagnosis was a mononeuritis multiplex with severe motor and sensory involvement; only the nerve biopsy allowed definite diagnosis and introduction of chemotherapy, leading to resolution of sensory deficit and progressive motor improvement.DiscussionNeuroleukemiosis caused by chronic lymphoid leukemia is an exceptional diagnosis. The presence of other possible causes like cryoglobulinemia could induce avoidance of nerve biopsy thus undertreating patient, since steroid treatment is not expected to be efficient on lymphocytic proliferation. Our case stretches the importance of nerve biopsy and raises neuromuscular specialist's awareness of this rare entity. To report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex.AIMSTo report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex.The patient underwent extensive evaluation, including nerve conduction study and myography, brain and plexus MRI, and nerve biopsy.METHODSThe patient underwent extensive evaluation, including nerve conduction study and myography, brain and plexus MRI, and nerve biopsy.The clinical and electrophysiological diagnosis was a mononeuritis multiplex with severe motor and sensory involvement; only the nerve biopsy allowed definite diagnosis and introduction of chemotherapy, leading to resolution of sensory deficit and progressive motor improvement.RESULTSThe clinical and electrophysiological diagnosis was a mononeuritis multiplex with severe motor and sensory involvement; only the nerve biopsy allowed definite diagnosis and introduction of chemotherapy, leading to resolution of sensory deficit and progressive motor improvement.Neuroleukemiosis caused by chronic lymphoid leukemia is an exceptional diagnosis. The presence of other possible causes like cryoglobulinemia could induce avoidance of nerve biopsy thus undertreating patient, since steroid treatment is not expected to be efficient on lymphocytic proliferation. Our case stretches the importance of nerve biopsy and raises neuromuscular specialist's awareness of this rare entity.DISCUSSIONNeuroleukemiosis caused by chronic lymphoid leukemia is an exceptional diagnosis. The presence of other possible causes like cryoglobulinemia could induce avoidance of nerve biopsy thus undertreating patient, since steroid treatment is not expected to be efficient on lymphocytic proliferation. Our case stretches the importance of nerve biopsy and raises neuromuscular specialist's awareness of this rare entity. Aims To report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex. Methods The patient underwent extensive evaluation, including nerve conduction study and myography, brain and plexus MRI, and nerve biopsy. Results The clinical and electrophysiological diagnosis was a mononeuritis multiplex with severe motor and sensory involvement; only the nerve biopsy allowed definite diagnosis and introduction of chemotherapy, leading to resolution of sensory deficit and progressive motor improvement. Discussion Neuroleukemiosis caused by chronic lymphoid leukemia is an exceptional diagnosis. The presence of other possible causes like cryoglobulinemia could induce avoidance of nerve biopsy thus undertreating patient, since steroid treatment is not expected to be efficient on lymphocytic proliferation. Our case stretches the importance of nerve biopsy and raises neuromuscular specialist's awareness of this rare entity. To report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex. The patient underwent extensive evaluation, including nerve conduction study and myography, brain and plexus MRI, and nerve biopsy. The clinical and electrophysiological diagnosis was a mononeuritis multiplex with severe motor and sensory involvement; only the nerve biopsy allowed definite diagnosis and introduction of chemotherapy, leading to resolution of sensory deficit and progressive motor improvement. Neuroleukemiosis caused by chronic lymphoid leukemia is an exceptional diagnosis. The presence of other possible causes like cryoglobulinemia could induce avoidance of nerve biopsy thus undertreating patient, since steroid treatment is not expected to be efficient on lymphocytic proliferation. Our case stretches the importance of nerve biopsy and raises neuromuscular specialist's awareness of this rare entity.
Author	Cochet, Stéphane Ribi, Camillo Vicino, Alex Brouland, Jean‐Philippe Théaudin, Marie Conrad, Curdin Pistocchi, Silvia Du Pasquier, Renaud
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Snippet	Aims To report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex. Methods The... To report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex. The patient... AimsTo report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex.MethodsThe... To report an exceptional case of nerve infiltration by an otherwise benign chronic B cell leukemia, inducing severe mononeuritis multiplex.AIMSTo report an...
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SubjectTerms	Biopsy Biopsy - adverse effects Chemotherapy Chronic lymphocytic leukemia chronic lymphoid leukemia Cryoglobulinemia Diagnosis Humans Leukemia, Lymphocytic, Chronic, B-Cell - complications Lymphatic leukemia Magnetic Resonance Imaging mononeuritis multiplex Mononeuropathies - diagnosis Mononeuropathies - drug therapy Mononeuropathies - etiology Nerve conduction Nerve Conduction Studies neuroleukemiosis neurolymphomatosis Patients
Title	A severe case of neuroleukemiosis caused by B cell chronic lymphocytic leukemia, presenting as mononeuritis multiplex
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