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Hodgkin disease after renal transplantation in childhood
R K Goyal1, L McEvoy, D B Wilson
1Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, Missouri 63110, USA.
Purpose:
Hodgkin disease (HD) has rarely been described in organ transplant recipients. We herewith report two cases of Epstein Barr virus (EBV)-associated HD that occurred in renal transplant recipients during childhood.
Patients:
A 19-year-old who had a renal transplant at 12 years of age developed mixed cellularity HD 1 year following diagnosis of an EBV-associated lymphoproliferative disorder. The second case is an 18-year-old man who developed nodular sclerosing HD 7 years after renal transplantation.
Results:
EBV latent membrane protein-1 antigen was strongly expressed in the Hodgkin Reed-Sternberg cells in both cases. These patients achieved complete remission with standard chemotherapy without unusual toxicity.
Conclusions:
Renal transplant recipients on immunosuppressive therapy can develop Hodgkin disease. A review of literature on this subject with emphasis on recent molecular studies on EBV-associated cases and observed increase in incidence of HD in HIV seropositive individuals is presented.