[Acute sensory neuropathy associated with Hodgkin's lymphoma: a case study]

Rinsho Shinkeigaku. 2019 Jun 22;59(6):349-355. doi: 10.5692/clinicalneurol.cn-001271. Epub 2019 May 29.
[Article in Japanese]

Abstract

The case of a 17-year-old man with Hodgkin's lymphoma who presented with paraneoplastic sensory neuropathy is presented. The patient visited our hospital because of acute progression of dysesthesiae in the bilateral face and extremities. He also developed an ataxic gait due to decreased deep sensation. Post-contrast T1-weighted MRI showed enhancement of both trigeminal nerves and the cauda equina. Cerebrospinal fluid examination was unremarkable. Intravenous immunoglobulin therapy and subsequent steroid pulse therapy did not improve his symptoms. Laboratory data showed an elevated serum soluble interleukin-2 receptor level. His chest X-ray and CT showed enlarged lymph nodes in the mediastinum, and the histopathologic examination of a lymph node biopsy specimen showed classical Hodgkin's lymphoma. He was treated with chemotherapy. His symptoms of neuropathy improved promptly while the lymphoma was being successfully treated, and he was able to walk with a cane. The present case was characterized by paraneoplastic sensory neuropathy as the initial clinical feature in association with Hodgkin's lymphoma. It is necessary to consider a paraneoplastic neurological syndrome even in a young patient with acute/subacute sensory neuropathy. Paraneoplastic sensory neuropathy associated with Hodgkin's lymphoma could be expected to improve with oncotherapy, and examination of the malignancy and early treatment are important.

Keywords: Hodgkin’s lymphoma; lymphoma; paraneoplastic neurological syndrome; sensory neuropathy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Ataxia / drug therapy
  • Ataxia / etiology
  • Bleomycin / administration & dosage
  • Dacarbazine / administration & dosage
  • Doxorubicin / administration & dosage
  • Hodgkin Disease / complications*
  • Hodgkin Disease / diagnosis
  • Hodgkin Disease / drug therapy*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mediastinal Neoplasms / complications*
  • Mediastinal Neoplasms / diagnosis
  • Mediastinal Neoplasms / drug therapy*
  • Paraneoplastic Polyneuropathy / drug therapy*
  • Paraneoplastic Polyneuropathy / etiology*
  • Paresthesia / drug therapy*
  • Paresthesia / etiology*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vinblastine / administration & dosage

Substances

  • Bleomycin
  • Vinblastine
  • Dacarbazine
  • Doxorubicin

Supplementary concepts

  • ABVD protocol