Aguilar-Silva A, Del Carpio-Orantes L, García-Nieva AA, Villegas-Domínguez JE

Language: Spanish
References: 16
Page: 921-927
PDF size: 457.95 Kb.

ABSTRACT

Background: Nephrotic syndrome can be an initial manifestation of Hodgkin lymphoma, associated as a paraneoplastic syndrome, it is a rare manifestation with an estimated incidence of 0.6% to 1%.
Clinical case: A 17-year-old female patient who, 4 months before the diagnosis of Hodgkin lymphoma, presented nephrotic syndrome that responded appropriately to steroids, developed B symptoms plus palpable supraclavicular lymphadenopathy in her evolution; it was performed a biopsy with diagnosis of Hodgkin lymphoma nodular sclerosis variant.
Conclusions: Rarely, nephrotic syndrome is reported in adults as paraneoplastic manifestation of malignancy, more specific Hodgkin lymphoma, in Mexico there are limited reports on this association; in the diagnostic protocol of nephrotic syndrome the coexistence with neoplastic diseases, such as reported in this case, should be considered.

REFERENCES

1. Piris P, Medeiros J, Chang KC. Hodgkin lymphoma: a reviewof pathological features and recent advances in pathogenesis.Pathology 2019; 52 (1): 154-165. doi: 10.1016/j.pathol.2019.09.005.

2. Swerdlow SH, Campo E, Harris NL, et al., editors. WHOClassification of Tumours of Haematopoietic and LymphoidTissues. Revised 4th ed. Lyon: IARC, 2017.

3. Appel GB, Radhakrishnan J, D’Agati D, Brenner and Rector'sThe Kidney. Secondary Glomerular Disease 2020; 32:1092-1164.e28

4. Galloway J. Remarks on Hodgkin’s disease. Br Med J 1922;2 (3234): 1201-1208.2. doi: 10.1136/bmj.2.3234.1201.

5. Plager J, Stutzman L. Acute nephrotic syndrome as a manifestationof active Hodgkin's Disease. Report of four casesand review of the literature. Am J Med 1971; 50: 56-66.https://doi.org/10.1016/0002-9343(71)90205-1.

6. Audard V, Larousserie F, Grimbert P, Abtahi M, et al.Minimal change nephrotic syndrome and classicalHodgkin’s lymphoma: report of 21 cases and review of theliterature. Kidney Int 2006; 69: 2251-2260. doi: 10.1038/sj.ki.5000341.

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

8. Stéphan JL, Deschênes G, Pérel Y, Bader-Meunier B, Brunat-Mentigny M, Lejars O, et al. Nephrotic syndrome andHodgkin disease in children: a report of five cases. Eur JPediatr 1997; 156: 239-242. doi: 10.1007/s004310050592.

9. Alpers CE, Cotran RS. Neoplasia and glomerular injury.Kidney Int 1986; 30: 465-473. doi: 10.1038/ki.1986.209.

10. Papper S. Nephrotic syndrome and neoplasm. The findingsto date, with practical implications. Postgrad Med 1984; 76:147-58. doi: 10.1080/00325481.1984.11698785.

11. Audard V, Zhang SY, Copie-Bergman C, Rucker-Martin C,et al. Occurrence of minimal change nephrotic syndromein classical Hodgkin lymphoma is closely related to theinduction of c-mip in Hodgkin-Reed Sternberg cells andpodocytes. Blood 2010; 115: 3756-3762. doi: 10.1182/blood-2009-11-251132.

12. Eremina V, Sood M, Haigh J, Nagy A, et al. Glomerularspecificalterations of VEGF-A expression lead to distinctcongenital and acquired renal diseases. J Clin Invest 2003;111: 707-716. doi: 10.1172/JCI17423.

13. Aggarwal N, Batwara R, McCarthy ET, Sharma R, Sharma M,Savin VJ. Serum permeability activity in steroid-resistantminimal change nephrotic syndrome is abolished bytreatment of Hodgkin disease. Am J Kidney Dis 2007; 50:826-9. doi: 10.1053/j.ajkd.2007.06.021.

14. Wągrowska-Danilewicz M, Danilewicz M. Nephrotic syndromeand neoplasia: our experience and review of theliterature. Pol J Pathol. 2011; 62: 12-18.

15. Eagen JW, Lewis EJ. Glomerulopathies of neoplasia. KidneyInt 1977; 11: 297-303.

16. 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.