Guillain-Barre syndrome in a haemoglobin S patient.

A 43 year old female sickle cell anaemia patient who had a mild clinical course of the disease developed ascending paralysis, areflexia, sensory disturbance and bulbar affectation while on therapy with vitamin B12 for neurological complications of megalobalstic anaemia. She had initially presented with a history of paresthesia involving all extremities and moderate pain in both feet. Blood smear picture revealed macro-ovalocytosis and hyper-segmented neutrophils.