Rinsho Shinkeigaku (Clinical Neurology)

Case Report

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

Yuki Yokota, M.D.1), Kazutaka Mitsuke, M.D.1), Hiroko Minami, M.D.1)2), Akihiko Morita, M.D.1), Hiromichi Takahashi, M.D.3)4) and Satoshi Kamei, M.D.1)

1)Division of Neurology, Department of Medicine, Nihon University School of Medicine
2)Present address: Department of Internal Medicine, Ryusei Hospital
3)Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine
4)Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine

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.
Full Text of this Article in Japanese PDF (634K)

(CLINICA NEUROL, 59: 349|355, 2019)
key words: paraneoplastic neurological syndrome, lymphoma, Hodgkin's lymphoma, sensory neuropathy

(Received: 10-Jan-19)