{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:52:49Z","timestamp":1755798769689,"version":"3.44.0"},"reference-count":9,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of the Child Neurology Society"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Neuroleukemiosis, leukemic infiltration of the peripheral nervous system (PNS), is rare. Very few cases of isolated neuroleukemiosis, PNS leukemic infiltration without leukemia blasts in the blood or bone marrow, have been reported in pediatrics. Most cases have occurred in adults with acute myelogenous leukemia (AML) in remission who presented with peripheral neuropathy. We describe a pediatric patient presenting with isolated neuroleukemiosis mimicking Guillain\u2010Barr\u00e9 syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient description<\/jats:title><jats:p>A 15\u2010year\u2010old boy presented 1 month after IVIG treatment for Guillain\u2010Barre syndrome\u00a0with worsening ataxia and weakness. He had a past medical history of B\u2010cell acute lymphoblastic leukemia (B\u2010ALL) in remission for 8 years. Examination revealed distal greater than proximal weakness of the bilateral lower extremities, areflexia at the Achilles tendon, and 1+ patellar and upper extremity reflexes. Initial magnetic resonance imaging (MRI) of the brain and spine were normal, and lumbar puncture revealed increased protein with uninterpretable white count due to excessive red blood cells. Repeat MRI brain and spinal cord showed extensive enlargement of all nerve roots and enhancement of the cauda equina and portions of cranial nerve VII bilaterally. Repeat lumbar puncture with cytology revealed leukemic blast cells. Blasts were not detected in peripheral blood smear or by flow cytometry. Bone marrow biopsy was also free of blast cells, confirming the diagnosis of relapsed B\u2010ALL restricted to the nervous system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neuroleukemiosis is a rare entity with typical clinical features of mono\u2010 or polyneuropathy. It most often occurs in adults in remission from AML. However, neuroleukemiosis should also be on the differential for pediatric patients in remission from ALL presenting with neuropathy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cns3.20095","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T02:39:45Z","timestamp":1731033585000},"page":"315-318","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Isolated peripheral neuroleukemiosis mimicking Guillain\u2010Barr\u00e9 syndrome in an adolescent with relapsed B\u2010lymphoblastic leukemia"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7575-1036","authenticated-orcid":false,"given":"Ethan","family":"Edmondson","sequence":"first","affiliation":[{"name":"Section of Pediatric Neurology and Developmental Neurosciences, Department of Pediatrics Texas Children's Hospital &amp; Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paisley","family":"Pauli","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurology and Developmental Neurosciences, Department of Pediatrics Texas Children's Hospital &amp; Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyotinder","family":"Punia","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology Texas Children's Hospital &amp; Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel G.","family":"Calame","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurology and Developmental Neurosciences, Department of Pediatrics Texas Children's Hospital &amp; Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0250-9"},{"key":"e_1_2_6_3_1","first-page":"422","article-title":"Cerebrospinal fluid analysis","volume":"103","author":"Shahan B","year":"2021","journal-title":"Am Fam Physician"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1532\/IJH97.A10703"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21089"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24435"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-022-05951-x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt285"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16073"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232214222"}],"container-title":["Annals of the Child Neurology Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cns3.20095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T13:57:36Z","timestamp":1755611856000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cns3.20095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,7]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/cns3.20095"],"URL":"https:\/\/doi.org\/10.1002\/cns3.20095","archive":["Portico"],"relation":{},"ISSN":["2831-3267","2831-3267"],"issn-type":[{"type":"print","value":"2831-3267"},{"type":"electronic","value":"2831-3267"}],"subject":[],"published":{"date-parts":[[2024,11,7]]},"assertion":[{"value":"2024-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}