Hodgkin disease in a patient with common variable immunodeficiency

Area of Science:

• Immunology
• Oncology
• Hematology

Background:

• Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by hypogammaglobulinemia, recurrent infections, and autoimmune disorders.
• Hodgkin disease (HD) is a malignancy of the lymphatic system, with extralymphatic involvement indicating advanced disease.
• The interplay between primary immunodeficiencies and the development of malignancies like HD is complex and not fully understood.

Observation:

• A young male patient presented with common variable immunodeficiency (CVID), exhibiting hypogammaglobulinemia, recurrent sinopulmonary infections, and autoimmune phenomena.
• The patient subsequently developed extensive extralymphatic Hodgkin disease, indicating a rare and aggressive presentation.
• Both humoral and cell-mediated immune functions were compromised prior to therapeutic intervention.

Findings:

• The patient received two cycles of chemotherapy for extralymphatic Hodgkin disease.
• Despite prophylactic gammaglobulin replacement, the patient experienced irreversible shock and succumbed to overwhelming infection.
• This case represents a previously unreported association between extralymphatic Hodgkin disease and primary immunodeficiency.

Implications:

• This case underscores the complex relationship between primary immunodeficiencies and the risk of developing aggressive malignancies.
• The findings suggest that patients with CVID may be at increased risk for unusual presentations of Hodgkin disease.
• Further research is warranted to elucidate the mechanisms underlying this association and to inform clinical management strategies for immunocompromised patients with cancer.