IMMUNE THROMBOCYTOPENIA AND HEMOLYTIC-ANEMIA ASSOCIATED WITH HODGKIN DISEASE

Purpose: We discuss an unusual clinical presentation of Hodgkin diseas e with immune thrombocytopenia and autoimmune hemolytic anemia. Patien ts and Methods: A 4-year-old boy presented to us with a large anterior mediastinal mass, thrombocytopenia, and Coombs' positive hemolytic an emia refractory to transfusion therapy. Biopsy of the anterior mediast inal mass was possible only after administration of intravenous immuno globulin to raise the platelet count. The immune manifestations decrea sed with initiation of appropriate chemotherapy. Result: The child was able to successfully complete chemotherapy and radiation therapy and has no clinical or laboratory evidence of persistent autoimmune phenom ena. Conclusion: Immune thrombocytopenia with autoimmune hemolytic ana emia is a rare presenting manifestation of Hodgkin disease and can pre sent difficulty in diagnosis and management.