Case reportParaneoplastic Nephrotic Syndrome and Inflammatory Arthritis at Diagnosis in Hodgkin Lymphoma
Introduction
Paraneoplastic manifestations occur in approximately 10% of all malignancies and their presence can complicate diagnosis and therapy. When confronted with unusual conditions, the physician must be cognizant of possible malignancy.
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Case Report
A 38-year-old Hispanic man presented with 1 month of migratory joint pain and swelling. He denied recent upper respiratory illness, pharyngitis, rash, or other symptoms. Medical history was noncontributory. He took ibuprofen for pain and denied drug, tobacco, or alcohol use.
Physical examination was notable for lower extremity edema and 3 palpable right supraclavicular lymph nodes. Initial laboratory assessment is in Table 1. Though his hematologic evaluation was consistent with anemia (white
Discussion
Recent reviews of Hodgkin lymphoma highlight the unusual paraneoplastic manifestations that might occur.1, 2, 3 Nephrotic syndrome occurs in 0.1%–0.5% of Hodgkin lymphoma (0.4% as minimal change disease and 0.1% as amyloid) and membranous nephropathy is the most common cause of nephrotic syndrome in solid tumors.4 A recent review recommends renal biopsy in nephrotic syndrome associated with malignancy, but notes that the primary treatment is directed at the tumor.5 In our case, considering the
Disclosure
All authors have no conflicts of interest.
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Cited by (4)
Paraneoplastic arthritides: an up-to-date case-based systematic review
2022, ReumatologiaA Case of Chorioretinopathy As First Manifestation of Hodgkin'S Lymphoma
2016, Retinal Cases and Brief Reports