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Cheptou M, Pichault V, Campagni R, Vodoff MV, Fischbach M, Paillard C. [Hodgkin disease revealed by a nephrotic syndrome: A case report]. Arch Pediatr 2015; 22:1268-71. [PMID: 26598043 DOI: 10.1016/j.arcped.2015.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/04/2015] [Accepted: 09/14/2015] [Indexed: 10/22/2022]
Abstract
Pediatric nephrotic syndrome (NS) is most often idiopathic or primary but in rare cases, it can be secondary to neoplasia. We report on a case of steroid-resistant NS revealing as a paraneoplastic syndrome of Hodgkin disease (HD) in a 12-year-old boy. The onset of the NS can be earlier, later, or simultaneous to the HD. Treatment of the lymphoma allows the disappearance of the NS. In the case we observed, the diagnosis of HD was delayed because HD presented with an isolated, hilar adenopathy in the absence of retroperitoneal or peripheral locations. In children aged 10 years or more presenting with NS, steroid-resistant or otherwise, a possible paraneoplastic origin such as Hodgkin lymphoma should always be taken into consideration and eventually eliminated.
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Affiliation(s)
- M Cheptou
- Pôle médicochirurgical pédiatrique, service de pédiatrie III, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - V Pichault
- Service de pédiatrie, hôpital du Hasenrain, 87, avenue d'Altkirch, BP 1070, 68051 Mulhouse cedex, France.
| | - R Campagni
- Service de pédiatrie, hôpital du Hasenrain, 87, avenue d'Altkirch, BP 1070, 68051 Mulhouse cedex, France
| | - M-V Vodoff
- Service de pédiatrie, hôpital du Hasenrain, 87, avenue d'Altkirch, BP 1070, 68051 Mulhouse cedex, France
| | - M Fischbach
- Pôle médicochirurgical pédiatrique, service de pédiatrie I, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - C Paillard
- Pôle médicochirurgical pédiatrique, service de pédiatrie III, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France
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Gargah T, Goucha-Louzir R, Lakhoua MR. Place du mycophénolate mofétil dans la néphropathie lupique proliférative de l’enfant. Nephrol Ther 2010; 6:564-8. [DOI: 10.1016/j.nephro.2010.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2010] [Revised: 07/06/2010] [Accepted: 07/06/2010] [Indexed: 11/15/2022]
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de Mello VR, Rodrigues MT, Mastrocinque TH, Martins SPL, de Andrade OVB, Guidoni EBM, Scheffer DK, Martini Filho D, Toporovski J, Benini V. Mycophenolate mofetil in children with steroid/cyclophosphamide-resistant nephrotic syndrome. Pediatr Nephrol 2010; 25:453-60. [PMID: 19937060 DOI: 10.1007/s00467-009-1356-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Revised: 09/15/2009] [Accepted: 09/17/2009] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to assess the results of therapy with mycophenolate mofetil (MMF) in children with idiopathic nephrotic syndrome (INS) who were both steroid- and cyclophosphamide-resistant. Treatment lasted a minimum of 6 months, and follow-up data were collected over a 2-year period. The children were divided into two groups: Group 1 (n=34) comprised patients who had received cyclosporine A (CsA) before the initiation of MMF therapy; Group 2 (n=18) comprised patients who received only MMF. Among the 34 patients of Group 1, complete and partial remission were achieved in seven (20.6%) and 13 patients (38.6%), respectively; there was no response in 14 patients (41.2%). Among the 18 patients in Group 2, complete and partial remission occurred in five (27.8%) and six (33.3%) patients, respectively; there was no response in seven patients (38.9%). Eight patients developed chronic kidney disease. The main side-effects were gastrointestinal complaints (n=11, 21%), recurring severe infections (n=1, 1.9%), and mild thrombocytopenia/leucopenia (n=1, 1.9%). MMF proved to be therapeutically effective in 59.5% of the cases. These beneficial effects need to be confirmed in studies with a long-term follow-up after discontinuation of the treatment. Our statistical analysis of the results of therapy with MMF did not reveal any significant difference between its use alone or following CsA administration.
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Affiliation(s)
- Valderez Raposo de Mello
- Department of Pediatrics, Division of Pediatric Nephrology, Santa Casa de São Paulo, Rua Cesario Motta Jr, 112 ZC 01221-020 São Paulo, Brazil
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