Doinita SFRIJAN, Simina-Maria VISAN, Sabina ZURAC, Bianca DIACONU and Cristian SCURTU

ABSTRACT

Sweet’s Syndrome also knows as acute febrile neutrophilic dermatosis, is a rare skin’s condition, that can occur either idiopathic or secondary. In the case of the latter, the syndrome can develop after certain malignancies (paraneoplastic syndrome), because of exposure to some medication or post infectious. It is more frequent in women aged between 30 and 50 years, but concerning children, the disorder is extremely rare (8% of the total number of cases), having equal sex ratio distribution. We present the case of an 11 year old male, diagnosed with systemic form of SS associated with Myelodysplastic Syndrome. The onset of the hematological condition seemingly occurred at the age of 5, when the diagnosis of chronic immune thrombocytopenic purpura was established. The treatment included repeated cortisone administrations, followed by a splenectomy procedure. Admitted in our Oncopaediatric department in December 2012, the child is given the diagnosis of MS, to which severe systemical manifestations of SS were added, with partial treatment response (cortisone, cyclosporine, dapsone, indomethacin). An allogeneic bone marrow transplant was conducted at Fundeni Institute (February 2015) when the SS remission occurred, but the progression was fatal, the child developing graft-versus-host disease.

Keywords: Sweet’s Syndrome, Myelodysplastic Syndrome, Immune Thrombocytopenic Purpura, child

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Doinita SFRIJAN, Ioana TIERANU, Loredana POPA, Iulia NECULA and Mihaela BALGRADEAN

ABSTRACT

Background: There is enough literature data - case reports and case series - regarding the association between nephrotic syndrome (NS) and different neoplasia, but only a few of these data address the specific link between NS and Hodgkin lymphoma. It has been demonstrated that intrinsic renal lesions – glomerular injury – can be found as a complication in these malignancies.

Material and methods: This report presents the case of a 9 year-old child in whom the diagnosis of NS was established two months before the diagnosis of Hodgkin lymphoma. Once chemotherapy was initiated, proteinuria and the clinical manifestations of NS, mainly oedema, disappeared.

Conclusion: Considering that the NS can be a paraneoplastic manifestation of Hodgkin lymphoma, the careful clinical evaluation becomes mandatory in any child with NS and persistent proteinuria despite appropriate treatment protocol. The prognosis of these patients is good, the treatment of Hodgkin disease causing the disappearance of proteinuria.

Keywords: nephrotic syndrome, paraneoplastic syndrome, Hodgkin lymphoma, children

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