Nephrotic Syndrome as a Paraneoplastic Syndrome of Hodgkin’s Disease: Case Report

Abstract

Nephrotic syndrome is a known but rare paraneoplastic syndrome accompanying Hodgin's disease. Nephrotic syndrome may precede, coincide or follow the diagnosis of malignancy. Minimal change glomerular nephropathy is the most frequently observed renal lesion. The immunopathological background of this entity is unknown. But, it is thought that T-cell dsyfunction leads to a secretion of cytokines which alters the permeability of the glomerular basement membrane. The clear recognition of a paraneoplastic syndrome is important, as it is often only necessary to treat the malignancy. In this report, we describe a-3-year-old boy who presented as nephrotic syndrome at 16 months prior to the diagnosis of Hodgin's disease . Key words: Paraneoplastic Syndrome, Hodgkin's Disease

Keywords

• Paraneoplastic Syndrome, Hodgkin's Disease

Hodgkin Hastalığında Paraneoplastik Sendrom Olarak Nefrotik Sendrom: Olgu Sunumu

Öz

Nefrotik sendrom, Hodgkin hastalığında iyi bilinen ancak nadir görülen bir paraneoplastik sendromdur. Nefrotik sendrom malignensiden önce, malignensi ile eşzamanlı veya malignensiyi izleyerek ortaya çıkabilir. Minimal lezyon hastalığı en sık görülen renal lezyondur. Paraneoplastik sendromun immunupatolojik mekanizması tam olarak bilinmemektedir. Ancak, glomerular bazal membran geçirgenliğini değiştiren sitokinlerin salınımına yol açan bir T hücre disfonksiyonunun olduğu düşünülmektedir. Sıklıkla yalnızca malignensi tedavisinin yeterli olması nedeni ile paraneoplastik sendromun tanımlanması önemlidir. Bu makalede Hodgkin hastalığı tanısından 16 ay önce nefrotik sendrom kliniğini ile başvuran 3 yaşında erkek olgu sunuldu. Anahtar kelimeler: Paraneoplastik Sendrom, Hodgkin Hastalığı

Anahtar Kelimeler

• Paraneoplastik Sendrom, Hodgkin Hastalığı

Kaynakça

1. Ronco PM. Paraneoplastic glomerulopathies: new insights into an old entity. Kidney Int 1999;56(1):355–77.
2. Galloway J. Remarks on Hodgkin’s disease. Br Med J 1922;2:1201–4.
3. Alpers CE, Cotran RS. Neoplasia and glomerular injury. Kidney Int 1986;30:465–473.
4. Stéphan JL, Deschênes G, Pérel Y, Bader-Meunier B, Brunat- Mentigny M, Lejars O, Lamagnères JP. Nephrotic syndrome and Hodgkin disease in children: a report of five cases. Eur J Pediatr 1997;156(3):239–42.
5. Mallouk A, Pham PT, Pham PC. Concurrent FSGS and Hodgkin's lymphoma: case report and literature review on the link between nephrotic glomerulopathies and hematological malignancies. Clin Exp Nephrol 2006;10(4):284–9.
6. Raphaël MF, Groothoff JW, van den Berg H. Nephrotic syndrome as a paraneoplastic symptom of Hodgkin's disease in two children. Ned Tijdschr Geneeskd 2002;146(34):1595– 8.
7. Milteny Z, Keresztes K, Ujhelyi L, Kovács J, Illés A. Nephrotic syndrome in Hodgkin's disease Orv Hetil 2005;146(25):1357-60.
8. Baron F, Hermanne JP, Fassotte MF, Beguin Y, Fillet G. Clinical case of the month. The association of Hodgkin's disease and nephrotic syndrome. Rev Med Liege 1998;53(11):651-3.

9. Utsch B, Fleischhack G, Hasan C, Bode U. Nephrotic syndrome as paraneoplastic syndrome of Hodgkin disease. Eur J Pediatr 1999;158(9):768.
10. Bacchetta J, Juillard L, Cochat P, Droz JP. Paraneoplastic glomerular diseases and malignancies. Crit Rev Oncol Hematol 2008;12.
11. Spyridonidis A, Fischer KG, Glocker FX, Fetscher S, Klisch J, Behringer D. Paraneoplastic cerebellar degeneration and nephrotic syndrome preceding Hodgkin’s disease: case report and review of the literature. Eur J Haematol 2002;68:318–21.
12. Velosa JA, Holley KE, Torres VE, Offord KP. Significance of proteinuria on the outcome of renal function in patients with focal segmental glomerulosclerosis. Mayo Clin Proc 1983;58(9):568–77.