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Hodgkin's disease and renal paraneoplastic syndromes in childhood
M Büyükpamukçu1, V Hazar, K Tinaztepe
1Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Insights
Children with Hodgkin's disease (HD) can develop kidney problems (nephropathy), often as a paraneoplastic syndrome. Early detection of kidney issues in pediatric HD may indicate a poorer prognosis.
Area of Science:
- Pediatric Nephrology
- Pediatric Oncology
- Oncology
Background:
- Hodgkin's disease (HD) is a cancer of the lymphatic system. Nephropathy refers to kidney disease.
- Investigating the link between pediatric Hodgkin's disease and kidney disease is crucial for understanding disease progression and treatment outcomes.
Observation:
- A study of 661 children with Hodgkin's disease identified 10 cases (1.5%) with concurrent nephropathy.
- Among these cases, eight had biopsy-proven kidney disease, including AA type amyloidosis, membranoproliferative glomerulonephritis, and minimal change glomerulopathy.
Findings:
- The development of nephropathy in children with Hodgkin's disease can be a paraneoplastic phenomenon, appearing before diagnosis or during relapse.
- AA type amyloidosis was a significant finding, sometimes preceding the HD diagnosis, highlighting the importance of considering pre-existing kidney conditions.
Implications:
- Recognizing nephropathy as a potential paraneoplastic syndrome in pediatric Hodgkin's disease is vital for early diagnosis and management.
- The presence of renal paraneoplastic syndrome, even in early-stage pediatric Hodgkin's disease, may signify a poor prognostic indicator, necessitating closer patient monitoring.
Abstract:
The purpose of this study was to investigate children followed as having both Hodgkin's disease (HD) and nephropathy and discuss the factors which might play roles in the pathogenesis of this association by reviewing the pertinent literature. Our experience among 661 children with HD revealed ten cases (1.5%) with nephropathy; eight of these were biopsy proven. Tissue diagnoses were amyloidosis (AA type) in four cases, and membranoproliferative glomerulonephritis and minimal change glomerulopathy in two cases each. Sex distribution was equal. There was a predominance of the mixed cellular (MC) histologic type in our patients with HD. Nephropathy was shown to antedate the diagnosis of HD in two cases and to herald a relapse in one. In brief, the development of a nephropathy in a patient with HD can be considered as a paraneoplastic phenomenon. Renal amyloidosis may already be present at the time of diagnosis of HD and must be kept in mind as a cause of proteinuria due to preexisting nephropathy. Developing renal paraneoplastic syndrome, even in early-staged HD, in children, may be a poor prognostic factor.