Paraneoplastic nephrotic syndrome and inflammatory arthritis at diagnosis in Hodgkin lymphoma

Polyarthritis and membranoproliferative glomerulonephritis as paraneoplastic manifestation of Hodgkin's lymphoma: A case report and literature review

Paraneoplastic syndromes can be presented in multiple ways, which include endocrinological, hematologic, rheumatologic and nephrologic manifestations. While most of the publications described solid tumors as responsible for these manifestations, hematologic neoplasms are important cause to consider as part of the differential diagnosis. We report the case of a 46 year-old man with seronegative symmetric polyarthritis of large and small joints associated with membranoproliferative glomerulonephritis with deposits of immune complexes and acute impairment of renal function, as part of a paraneoplastic syndrome secondary of a classical Hodgkin lymphoma with bone marrow invasion, which reversed completely with chemotherapy treatment.

A CASE OF CHORIORETINOPATHY AS FIRST MANIFESTATION OF HODGKIN'S LYMPHOMA

PURPOSE

To report a case of chorioretinopathy, which preceded diagnosis of Hodgkin's lymphoma.

METHODS

Single patient case report.

RESULTS

A 61-year-old woman with a history of breast cancer in remission and low-grade follicular lymphoma without criteria of high tumor burden presented with bilateral multifocal chorioretinopathy. The usual etiologies of chorioretinopathy were excluded, and subsequent onset of fever and back pain revealed the diagnosis of Hodgkin's lymphoma. The evolution of this case of ocular involvement was concordant with that of Hodgkin's lymphoma.

CONCLUSION

The authors describe a case of Hodgkin's lymphoma postdating the onset of chorioretinopathy, emphasizing the need to research an underlying disorder when faced with any inflammatory intraocular disease, and the role of indocyanine green angiography in the diagnosis and follow-up of posterior uveitis.

Polyangiitis with granulomatosis as a paraneoplastic syndrome of B-cell lymphoma of the lacrimal gland

Introduction. The clinical course of an autoimmune paraneoplastic syndrome parallels the natural history of the primary malignancy. In most cases, such paraneoplastic are syndromes hardly distinguishable from idiopathic autoimmune diseases. A case of polyangiitis with granulomatosis as a paraneoplastic syndrome in a patient with B-cell Lymphoma of the lacrimal gland has not yet been reported. Case Presentation. We present the case of a male patient with a B-cell Lymphoma of the lacrimal gland, who debuted with symptoms similar to rheumatoid arthritis and acute renal failure, secondary to polyangiitis with granulomatosis. The current pathophysiological hypotheses explaining the relationship between a lymphoproliferative disease and an autoimmune paraneoplastic disorder are discussed. Conclusion. Tumor-associated segmental necrotizing glomerulopathy is a very rare manifestation of glomerular diseases. Some atypical clinical features should increase the suspicion of an underlying tumor, in which case it is essential to treat the primary neoplasia, in order to control the autoimmune manifestations.