Two Uncommon Paraneoplastic Neurological Syndromes in a Child With Hodgkin Lymphoma

Area of Science:

• Neurology
• Oncology
• Immunology

Background:

• Paraneoplastic neurological syndromes (PNS) are rare remote effects of cancer, typically immune-mediated.
• PNS can impact the central, peripheral, and autonomic nervous systems.
• PNS are less common in lymphomas than solid tumors, often due to late-stage presentation and lack of onconeural antibodies.

Observation:

• A pediatric patient with stage IIB Hodgkin lymphoma was observed.
• The patient presented with synchronous, dual PNS.
• The specific PNS manifestations were achalasia cardia and Holmes Adie pupil.

Findings:

• This case demonstrates a rare occurrence of dual PNS in a child with Hodgkin lymphoma.
• The simultaneous presentation of achalasia cardia and Holmes Adie pupil with lymphoma is noteworthy.
• The findings suggest a potential immune-mediated link between Hodgkin lymphoma and these specific neurological syndromes.

Implications:

• This case expands the understanding of PNS manifestations in pediatric lymphomas.
• It emphasizes the importance of considering PNS in children with lymphoma, even with atypical presentations.
• Further research into the immunological mechanisms underlying PNS in lymphoma is warranted.