Clinical Reasoning: Progressive Peripheral Neuropathy in a 66-Year-Old Woman With Sezary Syndrome

Neurology. 2024 Nov 26;103(10):e209983. doi: 10.1212/WNL.0000000000209983. Epub 2024 Oct 23.

Abstract

Evaluating patients with neuropathy is common, especially in elderly patients with comorbidities. Neuropathy can often be a manifestation of systemic diseases, cancer, or drug-induced toxicity; thus, the differential diagnosis is challenging. The mechanism of nerve damage can vary significantly, affecting the patient's therapeutic management. We describe a 66-year-old woman who presented with subacute and progressively worsening motor weakness of the lower extremities with bilateral numbness and tingling after a recent respiratory tract infection. Her medical history included diabetes mellitus and Sezary syndrome in the context of cutaneous T-cell lymphoma. This case emphasizes the significance of a detailed evaluation and considering clinical signs and electrophysiologic findings in patients with neuropathy and a history of hematologic malignancy. Early recognition and management can be crucial in shaping the clinical course of the disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Clinical Reasoning
  • Disease Progression
  • Female
  • Humans
  • Peripheral Nervous System Diseases* / diagnosis
  • Peripheral Nervous System Diseases* / etiology
  • Sezary Syndrome* / complications
  • Sezary Syndrome* / diagnosis
  • Skin Neoplasms / complications
  • Skin Neoplasms / diagnosis