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Sub-acute demyelinating neuropathy associated with an NK/T cell lymphoma
  1. A J Wills,
  2. S O’Connor,
  3. A McMillan
  1. Nottingham University Hospitals NHS Trust, Nottingham, UK
  1. Adrian J Wills, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; Adrian.wills{at}nuh.nhs.uk

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Extranodal NK/T-cell lymphoma of nasal type is a rare non-Hodgkin’s lymphoma. We report on a patient who developed a demyelinating neuropathy in association with her haematological illness.

Case report

A 29-year-old woman presented with a 6-week history of neurological disturbance. She initially noticed weakness and numbness of her left lower limb, progressing to involve the right leg. There was no sphincter disturbance or back pain. Ten days prior to admission, she developed right-sided facial weakness. She had been previously fit and well, except that 3 months earlier she had developed abnormal liver function tests, which were unexplained.

Examination revealed a right lower motor neurone facial palsy with impairment of taste sensation on the anterior two-thirds of the tongue (ipsilateral). Upper limb examination was normal. There was bilateral lower limb weakness, which was assymetrical (right worse than left) and more prominent proximally than distally. The left ankle jerk was absent but, during the course of her admission, all the lower limb reflexes disappeared. Both plantar responses were flexor. Sensory examination revealed patchy loss of pinprick sensation over both thighs (L2).

The following investigations were normal: full blood count, ESR, electrolytes, liver function tests (apart from γGT 74 IU/L), viral serology (including CMV/Epstein—Barr virus (EBV) IgM), TPHA, anti-nuclear factor, extractable nuclear antigens, cryoglobulins, …

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