Nephrotic syndrome preceding Hodgkin's disease by 42 months

A 52-year-old man developed minimal change nephrotic syndrome which responded only partially to prednisolone. The addition of cyclophosphamide resulted in a complete remission. During a second episode of nephrotic syndrome prednisolone and cyclophosphamide only gave a partial remission. During a third episode, 42 months after the initial presentation, Hodgkin's disease clinical stage IA was diagnosed. Mantle field radiation therapy was given after which proteinuria gradually decreased to zero in the course of 17 months. The patient has remained free of disease until now (15 months).