Estrada-Rivera EL, Mares-Gil JE, Gómez-González D, Colunga-Pedraza J, Velasco-Ruiz I, Jiménez-Antolinez V, González-Llano O

Language: Spanish
References: 15
Page: 153-156
PDF size: 214.27 Kb.

ABSTRACT

Hodgkin’s lymphoma is often associated with paraneoplastic syndromes, of these, renal involvement is one of the least frequent associations, particularly nephrotic syndrome. In children a low incidence is reported ranging from 0.6 to 1% in other countries. In Latin-American pediatric population there is a limited number of reports about the Hodgkin’s lymphoma and nephrotic syndrome association. In this article we discuss the case of a 5-year-old patient who developed clinical features of renal failure consistent with nephrotic syndrome, receiving treatment without significant improvement, prior to be diagnosed with Hodgkin’s lymphoma. We describe his evolution, treatment y current state. A clear physiopathology of the association between Hodgkin’s lymphoma and renal lesion has not been established; it has been linked to a disruption in the glomerular basement membrane permeability caused by T-cell dysfunction and abnormal cytokine production. In the Hodgkin’s lymphoma associated with nephrotic syndrome cases, patient evolution and prognosis depend on response to treatment of Hodgkin’s lymphoma. Hodgkin’s lymphoma and nephrotic syndrome association in pediatric patients is rare, so that in atypical presentations of nephrotic syndrome, steroid resistance or early relapse is important having it in mind.

REFERENCES

1. Tandra P, Kallam A, Guduru M, Sunil Bendi V, Krishnamurthy J, Bierman P. Paraneoplastic manifestations of lymphoproliferative neoplasms. Lymph Chronic Lymphoc Leuk 2016;6:21-33.

2. Sfrijan D, Tieranu I, Popa L, Necula I, Balgradean M. Nephrotic syndrome, paraneoplastic syndrome associated to Hodgkin lymphoma. Maedica J Clin Med 2016;11(5):64-67.

3. Alpers CE, Cotran RS. Neoplasia and glomerular injury. Kidney Int 1986;30:465-473.

4. Pourtsidis A, Doganis D, Baka M, Varvoutsi M, Kosmidis H. Nephrotic syndrome and Hodgkin lymphoma in children. Report of two cases. Hippokratia 2014;18(4):373-375.

5. Stephan JL, Deschênes G, Pérel Y, Bader-Meunier B, et al. Nephrotic syndrome and Hodgkin disease in children: a report of five cases. Eur J Pediatr 1997;156:239-242.

6. Büyükpamukçu M, Hazar V, Tinaztepe K, Bakkaloğlu A, Akyüz C, Kutluk T. Hodgkin’s disease and renal paraneoplastic syndromes in childhood. Turk J Pediatr 2000;42: 109-114.

7. Farruggia P, Trizzino A, Maringhini S, Grigoli A, Sapia Ch, D’Alessandro M, et al. Hodgkin lymphoma and nephrotic syndrome in childhood. Indian J Pediatr 2010;77:1147- 1149.

8. Audard V, Larousserie F, Grimbert P, Abtahi M, et al. Minimal change nephrotic syndrome and classical Hodgkin’s lymphoma: Report of 21 cases and review of the literature. Kidney Int 2006;69:2251-2260.

9. Gagliano RG, Costanzi JJ, Beathard GA, Sarles HE, Bell JD. The nephrotic syndrome associated with neoplasia: an unusual paraneoplastic syndrome. Report of a case and review of the literature. Am J Med 1976;60(7):1026-31.

10. Aggarwal N, Batwara R, McCarthy ET, Sharma R, Sharma M, Savin VJ. Serum permeability activity in steroidresistant minimal change nephrotic syndrome is abolished by treatment of Hodgkin disease. Am J Kidney Dis 2007;50(5):826-9.

11. Huisman RM, de Jong PE, de Zeeuw D, Van Imhoff GW, Van der Hem GK. Nephrotic syndrome preceding Hodgkin’s disease by 42 months. Clin Nephrol 1986;26(6):311-3.

12. Yung L, Linch D. Hodgkin’s lymphoma. Lancet 2003;361:943- 951.

13. Davidson A.M. Renal diseases associated with malignancies. Nephrol Dial Transplan 2001;16:13-14.

14. Nakayama S, Yokote T, Kobayashi K, Hirata Y, et al. Minimal change nephrotic syndrome preceding Hodgkin lymphoma by 5 years with expression of tumor necrosis factor alpha in Hodgkin-Reed-Sternberg cells. Hum Pathol 2010;41:1196-1199.

15. Cheptou M, Pichault V, Campagni R, Vodoff M-V, Fischbach M, Paillard C. Hodgkin disease revealed by a nephrotic syndrome: A case report. Arch Pédiatrie 2015;22:1268-1271.