Hodgkin's disease presenting as renal failure: improvement in renal lesion and renal function with chemotherapy

A 15 year old girl presented with weight loss, lymphadenopathy and severe renal failure. A diagnosis of Hodgkin's disease were made by biopsy of a lymph node. Renal biopsy findings included diffuse infiltration of the interstitium by lymphocytes and plasma cells. There was a mild increase in mesangial matrix in the glomeruli. Renal function returned to normal after she received chemotherapy for the Hodgkin's disease. This improvement was associated with a significant decrease in the renal interstitial infiltrate and by a significant decrease in the renal size on intravenous pyelography. It is unusual for patients with Hodgkin's disease to present in renal failure. We are unaware of any previous patient who presented in this manner and who survived with normal renal function. The patient is now apparently free of disease six years after her original illness.