A Case of Paraneoplastic Guillain-Barré Syndrome Associated with Squamous Cell Carcinoma of the Lung

Wu, Danwei; Liu, Anne; Baldinger, Esther; Frontera, Alfred T.

doi:10.7759/cureus.3202

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…Previous case-reports [5][6][7][8][9][10][11][12][13][14][15][16][17][18] and small cohort studies, 19,20 as well as the recent case-control study, 3 have reported cancers before, concomitantly with, and shortly after the diagnosis of GBS. These diverse approaches complicate the interpretation of the association, in terms of directionality.…”

Section: Discussionmentioning

confidence: 99%

“…31 The magnitude of risk and prevalence of small cell and non-small cell lung cancer in our GBS cohort, as well as results from past case reports, align with this evidence. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] A potential mechanism underlying the association between GBS and cancer is based on the observation that the cross-immunoreaction involving the tumor and peripheral nerves is caused by the presence of high levels of anti-GM1 ganglioside IgG autoantibodies, anti-Hu, and onconeural antibodies targeting antigen-specific T-lymphocytes. 9 However, evidence of the presence of these markers in GBS patients with malignancies is inconsistent.…”

Section: Discussionmentioning

confidence: 99%

“…4 However, whether GBS is a marker of occult cancer remains unclear. Available evidence is limited to case reports [5][6][7][8][9][10][11][12][13][14][15][16][17][18] and two small regional, single-hospital cohort studies, which included 435 and 109 GBS patients, respectively. 19,20 In both cohorts, a two-fold increased incidence of cancer was reported among GBS patients compared with the cancer incidence expected in the general population, based on nine and 10 cancer cases, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Cancer Diagnosis and Prognosis After Guillain–Barré Syndrome: A Population-Based Cohort Study

Girma

Farkas²,

Laugesen³

et al. 2022

CLEP

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Introduction It is unclear whether Guillain–Barré syndrome (GBS) can be a marker of a paraneoplastic syndrome. We examined whether GBS is associated with cancer and whether the prognosis of GBS patients with cancer differs from that of other cancer patients. Materials and Methods We conducted a population-based cohort study of patients diagnosed with GBS between 1978 and 2017 using Danish registry-data. Main outcome measures were cancer incidence and mortality after cancer diagnosis. We calculated absolute risks of a cancer diagnosis, treating death as competing risk, and standardized incidence ratios (SIRs) as measures of relative risk. We matched each GBS cancer patient with up to 10 cancer patients without a GBS diagnosis and examined the six-month survival after cancer diagnosis using Cox regression analysis. Results We identified 7897 patients (58% male, median age 57 years) with GBS. During a median follow-up of 9.5 years, the one-year risk of cancer was 2.7% (95% confidence interval (CI), 2.4–3.1). The SIR was increased throughout follow-up, but most noticeably during the first year after diagnosis (SIR: 3.35, 2.92–3.83). SIRs were particularly elevated for hematologic cancers (SIR: 8.67, 6.49–11.34), smoking-related cancers (SIR: 3.57, 2.81–4.47), and cancers of neurological origin (SIR: 8.60, 5.01–13.77). Lung cancer was the main contributor to the overall excess risk, which persisted after 36 months of follow-up (SIR: 1.17, 1.09–1.25). The mortality rate ratio comparing patients diagnosed with any cancer within one year of their GBS diagnosis and matched GBS-free cancer cohort members was 1.56 (95% CI, 1.27–1.90). Conclusion GBS patients had a three-fold increased risk of cancer diagnosis in the first year of follow-up. The absolute cancer risk was almost 3.0%. A GBS diagnosis was an adverse prognostic marker for survival following cancer diagnosis. Clinicians should consider occult cancer in patients hospitalized with GBS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cancer Diagnosis and Prognosis After Guillain–Barré Syndrome: A Population-Based Cohort Study

Girma

Farkas²,

Laugesen³

et al. 2022

CLEP

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“…In contrast, the association between GBS and malignancy is still debated as Graus et al do not define it as a paraneoplastic syndrome in the absence of high-risk antibodies 9. A number of case reports described GBS in patients with an existing or later diagnosed malignancy12–25 and a small number of population-based studies have identified an increased risk of cancer in patients who developed GBS 8 26 27. Nevertheless, it is not clear whether these findings demonstrate an actual causal link or simply two separate concurrent diagnoses.…”

Section: Discussionmentioning

confidence: 99%

Acute sensorimotor paraneoplastic neuropathy in a patient with small cell prostate cancer

Faggin,

McCann,

Gallagher

et al. 2024

BMJ Case Rep

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The authors describe a patient with a background of metastatic small cell prostate cancer who presented with a rapidly evolving sensorimotor neuropathy with bulbar features closely resembling Guillain-Barré syndrome, with a good initial response to intravenous immunoglobulins and platinum-based chemotherapy. This represented a likely paraneoplastic manifestation of the patient’s urological malignancy.

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“…Guillain-Barre Syndrome has been reported as a rare paraneoplastic syndrome, primarily in the setting of lung cancer and lymphoma. Notably, in several of these cases, antibody testing was negative [2][3][4][5]. It is unclear why certain malignancies have a greater predisposition to paraneoplastic syndromes.…”

Section: Introductionmentioning

confidence: 99%

Guillain-Barre Syndrome as a Paraneoplastic Syndrome from Ewing Sarcoma

MH¹,

Le²,

CW³

2021

sarcomaresint

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Background: Paraneoplastic syndromes have been associated with certain malignancies, classically with small cell lung cancer. However, there have been case reports of solid tumors that have been associated with paraneoplastic syndromes as well. This is believed to be the first case that details a young man with Ewing sarcoma who developed Guillain-Barre Syndrome in the form of a paraneoplastic syndrome. Case Presentation: A 23-year-old man with localized Ewing sarcoma presented to the hospital with weakness. He was initially treated with interval compressed chemotherapy and radiation, but developed recurrence and underwent hemipelvectomy. He had chronic numbness of his extremities from vincristine that felt acutely worsened over several days prior to admission. Additionally, he was now having difficulty grasping objects and walking. His exam was notable for mildly decreased strength in his lower extremities but preserved in his upper extremities along with intact extraocular movements. The following morning he was unable to move and lost all sensation in his left lower extremity along with new dysphagia. Urgent work-up revealed a normal MRI brain, MRI spine with enhancement of cauda equina nerve roots around the conus, and a lumbar puncture with cytoalbuminologic dissociation. Ultimately was diagnosed with presumed Guillain-Barre Syndrome and treated with IVIG. Conclusion: Guillain-Barre is a rare but serious syndrome that needs to be recognized quickly given its high mortality and morbidity rate and necessity of quick intervention. It is imperative for clinicians to maintain a high degree of clinical suspicion as a manifestation of paraneoplastic syndrome from malignancies.

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A Case of Paraneoplastic Guillain-Barré Syndrome Associated with Squamous Cell Carcinoma of the Lung

Cited by 3 publications

References 20 publications

Cancer Diagnosis and Prognosis After Guillain–Barré Syndrome: A Population-Based Cohort Study

Cancer Diagnosis and Prognosis After Guillain–Barré Syndrome: A Population-Based Cohort Study

Acute sensorimotor paraneoplastic neuropathy in a patient with small cell prostate cancer

Guillain-Barre Syndrome as a Paraneoplastic Syndrome from Ewing Sarcoma

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