Cheptou M, Pichault V, Campagni R, Vodoff M-V, Fischbach M, Paillard C
Pôle médicochirurgical pédiatrique, service de pédiatrie III, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
Service de pédiatrie, hôpital du Hasenrain, 87, avenue d'Altkirch, BP 1070, 68051 Mulhouse cedex, France.
Arch Pediatr. 2015 Dec;22(12):1268-71. doi: 10.1016/j.arcped.2015.09.008. Epub 2015 Nov 16.
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.
小儿肾病综合征(NS)大多为特发性或原发性,但在罕见情况下,它可能继发于肿瘤。我们报告一例12岁男孩的类固醇抵抗性NS,其表现为霍奇金病(HD)的副肿瘤综合征。NS的发病可能早于、晚于或与HD同时出现。淋巴瘤的治疗可使NS消失。在我们观察的病例中,HD的诊断被延迟,因为HD仅表现为孤立的肺门淋巴结病,而无腹膜后或外周部位受累。对于10岁及以上患有NS(无论是否为类固醇抵抗性)的儿童,应始终考虑并最终排除可能的副肿瘤性病因,如霍奇金淋巴瘤。