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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Bibliographic Details
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
Online Access:Get full text
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Summary: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.
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ISSN:1085-9489
1529-8027
1529-8027
DOI:10.1111/jns.12552