A Rare Case of Immune Thrombocytopenic Purpura in a Patient With Hodgkin Lymphoma: A Diagnostic Dilemma

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dc.contributor.authorOtokiti, O
dc.contributor.authorBolarinwa, A
dc.contributor.authorOgbenna, A
dc.date.accessioned2022-09-28T10:07:56Z
dc.date.available2022-09-28T10:07:56Z
dc.date.issued2018
dc.descriptionScholarly articleen_US
dc.description.abstractIntroduction: Paraneoplastic syndrome is a collective term for disorders arising from metabolic effects of cancer on tissues remote from the primary tumor. Such disorders maybe endocrine, hematologic, or neuromuscular disorders. Immune thrombocytopenia (ITP) is a rare PNS manifestation in Hodgkin lymphoma (HL). The prevalence of ITP associated with HL is unknown in Nigeria as there are few or no case reports. It is more common in males and is associated with autoimmune antibodies. Case Presentation: We present a 49-year-old man who presented with swelling on the tongue with numerous hemorrhagic bullaes and ecchymosis. He had a small lymph node in the right axilla and another in the inguinal region. Lymph node biopsy came out as benign lymphoid hyperplasia. A diagnosis of ITP was made based on severe thrombocytopenia, megakaryocytic hyperplasia, and a negative viral serology. He responded well to steroid but was switched to Eltrombobag when he became refractory to steroids. A repeat biopsy was done 5 months after, due to increasing right axillary lymphadenopathy that revealed a nodular lymphocyte-predominate HL (NLPHL). He requested to travel to India for further care. In India, he had six cycles of ABVD with rituximab. PET/CT scan after the second cycle showed a partial treatment response and after the sixth cycle showed complete resolution of right axillary lymph nodes. Platelet count has been within normal range and patient is alive and well. Conclusion: Hodgkin lymphoma can be associated with paraneoplastic hematologic syndromes, one of which is ITP. This could precede diagnosis of HL as in this case or present concomitantly. Sometimes it could be the only presenting feature of an underlying HL posing as a diagnostic dilemma. Therefore, a high index of suspicion is required to avoid diagnostic delay. Successful treatment of HL often reverses the hematologic paraneoplastic manifestations.en_US
dc.identifier.citationOtokiti, O., Bolarinwa, A. And Ogbenna, A. (2018). A Rare Case of Immune Thrombocytopenic Purpura in a Patient With Hodgkin Lymphoma: A Diagnostic Dilemma. American Journal of Clinical Pathology, 150, S92-S115.en_US
dc.identifier.other10.1093/ajcp/aqy097.237
dc.identifier.urihttps://ir.unilag.edu.ng/handle/123456789/11581
dc.language.isoenen_US
dc.publisherAmerican Journal of Clinical Pathologyen_US
dc.subjectParaneoplastic syndromeen_US
dc.subjectautoimmune antibodiesen_US
dc.subjectCanceren_US
dc.subjectTumouren_US
dc.subjectResearch Subject Categories::MEDICINEen_US
dc.titleA Rare Case of Immune Thrombocytopenic Purpura in a Patient With Hodgkin Lymphoma: A Diagnostic Dilemmaen_US
dc.typeArticleen_US
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