Guillain-Barré Syndrome as First Presentation of Non-Hodgkin's Lymphoma.

We present a woman referred with underlying non-Hodgkin's lymphoma (NHL) masquerading clinically with Guillain-Barré syndrome (GBS) like syndrome. At first evaluation, chest CT-Scan along with brain and whole spine MRI were normal. Electrodiagnostic studies were in favor of acute generalized polyradiculoneuropathy. Laboratory evaluation revealed hypoglycorrhachia. She treated with plasmapheresis after two weeks; she was discharged from hospital, but neurological recovery was not complete. After 6 months, she came back with acute onset of weakness in lower limbs, back pain, fever and urinary incontinence. Pinprick and light touch complete sensory loss was found beneath umbilicus. Thoracic MRI with contrast revealed a dorsal epidural mass extending smoothly from T8 to T12 (10 cm) with spinal cord compression. She underwent urgent laminectomy for spinal cord decompression. Histological examination revealed small round cell tumor suggestive of malignant T-cell type lymphoma. In cases with Guillain-Barré syndrome presentation, systemic hematologic disorders such as non-Hodgkin's lymphoma should be considered as one of the differential diagnosis of underlying disease.

Elevated serum levels of lysophosphatidic acid in patients with multiple sclerosis.

A plethora of studies have shown that lysophosphatidic acid (LPA) is involved both in inflammation and T cell apoptosis evasion. The aim of this study was to measure the concentrations of LPA in serum of patients with multiple sclerosis (MS). Twenty MS patients along with 20age-sex matched healthy individuals were recruited for this investigation. By employment of ELISA method, we demonstrated that MS patients had higher levels of LPA in serum than control group (P=0.006). This study is the first report of LPA elevation in MS disease.