acute acquired demyelinating polyneuropathy:an initial presentation of diffuse large b cell lymphoma

neurological signs and symptoms are commonly associated with both hodgkin’s and non-hodgkin’s lymphoma and are mostly attributed to either direct lymphomatous involvement of the nervous system, either as a result of extension to the spinal cord or nerves, or due to infiltration by lymphoma cells and drug toxicity. guillain-barre syndrome and its variants have been reported very infrequently in the literature. we present the case of a 70-year-old male admitted to the hospital for evaluation of uncontrolled hypertension. incidentally, he was noted to have a low platelet count and a leukoerythroblastic picture in the peripheral blood. two days into admission, he developed bilateral symmetrical ascending paresis consistent with acute acquired demyelinating polyneuropathy, a common variant of guillain-barre syndrome. at about the same time he developed worsening cytopenia and was diagnosed with diffuse large b cell lymphoma according to a bone marrow biopsy. the patient was treated with intravenous immunoglobulin for guillain-barre syndrome with significant improvement in muscle strength and subsequently treated with chemotherapy for his lymphoma.