title: Guillain-Barre syndrome following 2-chlorodeoxyadenosine treatment for Hairy Cell Leukemia.
abstract: A 68-year-old man, with Hairy Cell Leukemia developed a Guillain-Barré syndrome (G-B), 32 days after a single course of 2-Chlorodeoxyadenosine (CDA) at 0,14 mg/k/d, for five days in a two-hour-i.v. infusion and following a febrile neutropenia episode. In order to clarify whether this G-B case was related to an infection or to CDA neurotoxicity, we screened for infection-related autoimmune G-B and for antibodies (abs.) against gangliosides of peripheral nerves. Blood and urinary cultures were negative as well as serum anti-virus abs. However, serum anti-ganglioside abs. were positive for anti-asialo GM1 and anti-Gd1b. This latter finding was consistent with an autoimmune mechanism, not described until now as CDA neurotoxicity. In the present case, we do not have enough evidence to link CDA administration to the G-B syndrome. We think that it is necessary to exclude other causes of neurotoxicity before considering CDA adverse effect.
authors.affiliation: Department of Clínica Hematológica, Instituto de Investigaciones Hematológicas Mariano R. Castex. Academia Nacional de Medicina de Buenos Aires, Argentina.
authors.forename: M A
authors.initials: MA
authors.lastname: Sarmiento
authors.forename: D
authors.initials: D
authors.lastname: Neme
authors.forename: M C
authors.initials: MC
authors.lastname: Fornari
authors.forename: R M
authors.initials: RM
authors.lastname: Bengió
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000097:blood; D017338:Cladribine / Q000008:administration & dosage / Q000009:adverse effects*; D005677:G(M1) Ganglioside / Q000276:immunology; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000139:chemically induced*; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D008297:Male
chemical_list: D001323:Autoantibodies; D005732:Gangliosides; C033851:ganglioside, GD1b; D005677:G(M1) Ganglioside; D017338:Cladribine; C018835:asialo GM1 ganglioside