key: cord-0748130-p6zajpeg
authors: Oumerzouk, J.; Zbitou, A.; Raissi, A.; Yahyaoui, H.; Louhab, N.; Khatouri, A.; Kissani, N.
title: Neurological relapse of acute lymphoblastic leukemia mimicking COVID-19associated Guillain-Barré Syndrome
date: 2022-05-23
journal: nan
DOI: 10.1016/j.phoj.2022.05.006
sha: d194bcd77221f531c3771903f610e5f294c94624
doc_id: 748130
cord_uid: p6zajpeg

nan

Oumerzouk J 1, 4 While some 5 to 8% of ALL cases will have neurological involvement at initial presentation, 30% of relapses entail neurological manifestations 4,6 . Neurological involvement remains a negative prognostic factor 4, 5 Our patient presented the Philadelphia mutation, that is the t(9;22), and thus was at high risk of neurological involvement. Recent advances in the fields of diagnostics and therapeutics have improved prognosis in patients. 2, 3, 6 Our patient presented, not only with cranial nerve involvement, but also polyradiculoneuritis.

While it stands to reason that the context of neoplastic history makes the B-cell ALL a very likely culprit, it must be pointed out that in the case of our patient, other differentials are important to discuss, mainly infectious and post infectious acute polyradicluloneuropathy GBS 4 , given the immunocompromised state and the current pandemic context (COVID19). 4, 7, 8 Nevertheless, toxic neuropathies should also be considered. Performing lumbar puncture (LP)

is an important procedure at the time of diagnosis and MRI is required if CNS involvement is suspected. 8, 9 Neurological examination and appropriate diagnostic workup are required to parse out the various differentials.

This case points to the need to have a high suspicion for neurological relapse in patients of ALL presenting with GBS like symptoms post COVID19.

Written and verbal consent for publication was obtained from the patient and his parents.

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The authors report no conflicts of interest.

No financial sources to declare