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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2015, Number 2

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Rev Esp Med Quir 2015; 20 (2)

Nephrotic syndrome as an initial manifestation of Hodgkin’s lymphoma

Hernández-Jamaica RM, Mirón-García J, Olalde-Carmona R

Language: Spanish
References: 18
Page: 237-242
PDF size: 505.46 Kb.


ABSTRACT

The link between the Nephrotic syndrome and malignancies was first described in 1922. NS can be the first manifestation of Hodgkin Lymphoma. Steroid resistance, relapse and the appearance of new signs and symptoms have been considered warning signs suggesting a secondary etiology.
Eight months before de diagnosis of Hodgkin Lymphoma, a 5 year old boy presented Nephrotic syndrome which responded well to supportive care and steroids. There were no adenopathy or any other manifestations of Hodgkin Lymphoma and a fast progression of edema was remarkable.
Nephrotic syndrome can precede the diagnosis of Hodgkin Lymphoma for several months. Although a clear association between both entities has been recognized, the pathogenic mechanisms are not well understood; however, several T-cell derived cytokines seem to play a critical role in the development of nephrotic proteinuria. The prognosis of Nephrotic syndrome in these cases relies upon the underlying lymphoma. Until the initiation of lymphoma directed therapy, supportive measures as well as the avoidance of any nephrotoxic medication are recommended while completing tumor staging with a strong consideration for tumor removal.


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