title: Neurological Nuance: Hodgkin lymphoma presenting with Guillain-BarrÉ syndrome.
abstract: Hodgkin lymphoma (HL) is a common lymphoid malignancy rarely associated with Guillain-Barré syndrome (GBS). In most cases, GBS does not precede HL.
  
  
  
  We describe a patient with acute inflammatory demyelinating polyneuropathy who fulfilled criteria for GBS that heralded undiagnosed HL.
  
  
  
  Cerebrospinal fluid (CSF) studies revealed albuminocytologic dissociation with significant protein elevation (250 mg/dl). The patient worsened during intravenous immunoglobulin (IVIg) therapy. Constitutional symptoms with elevated inflammatory markers prompted further investigation, and imaging revealed an anterior mediastinal mass confirmed on biopsy to be HL. Chemotherapy yielded early clinical improvement.
  
  
  
  GBS preceding HL is rare, and this case highlights the importance of considering HL in the setting of GBS. Marked elevations in CSF protein, ongoing deterioration despite administration of IVIg, and constitutional symptoms with elevated inflammatory markers may be clues to possible HL-induced GBS. Muscle Nerve 55: 601-604, 2017.
authors.affiliation: Department of Medicine (Neurology), University of Alberta, 7-132A Clinical Sciences Building, 11350-83 Avenue, Edmonton, Alberta, T6G 2G3, Canada.
authors.forename: Dustin
authors.initials: D
authors.lastname: Anderson
authors.affiliation: Department of Medicine (Neurology), University of Alberta, 7-132A Clinical Sciences Building, 11350-83 Avenue, Edmonton, Alberta, T6G 2G3, Canada.
authors.forename: Grayson
authors.initials: G
authors.lastname: Beecher
authors.affiliation: Department of Medicine (Neurology), University of Alberta, 7-132A Clinical Sciences Building, 11350-83 Avenue, Edmonton, Alberta, T6G 2G3, Canada.
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Steve
authors.affiliation: Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Ho
authors.initials: H
authors.lastname: Jen
authors.affiliation: Department of Medicine (Neurology), University of Alberta, 7-132A Clinical Sciences Building, 11350-83 Avenue, Edmonton, Alberta, T6G 2G3, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Camicioli
authors.affiliation: Department of Medicine (Neurology), University of Alberta, 7-132A Clinical Sciences Building, 11350-83 Avenue, Edmonton, Alberta, T6G 2G3, Canada.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Zochodne
mesh_terms: D000328:Adult; D020275:Guillain-Barre Syndrome / Q000134:cerebrospinal fluid / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D006689:Hodgkin Disease / Q000134:cerebrospinal fluid / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D049268:Positron-Emission Tomography; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: Guillain-Barré syndrome; Hodgkin lymphoma; acute inflammatory demyelinating polyneuropathy; intravenous immunoglobulin; paraneoplastic; peripheral nervous system