Case report
Paraneoplastic Nephrotic Syndrome and Inflammatory Arthritis at Diagnosis in Hodgkin Lymphoma

https://doi.org/10.1016/j.clml.2012.09.006Get rights and content

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)

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