SYSTEMIC LUPUS-ERYTHEMATOSUS AND HODGKINS LYMPHOMA

Objective. Systemic lupus erythematosus (SLE) is associated with lymph oproliferative diseases such as Hodgkin's lymphoma. Since there is con siderable overlap between the features of SLE and Hodgkin's lymphoma ( SLE/HL) there can be a great difficulty in diagnosing Hodgkin's lympho ma in the presence of SLE. Our objective was to determine the features that can suggest coexistent SLE/HL. Methods. We describe 3 cases of H odgkin's lymphoma that occurred in the setting of SLE and review the f eatures of 11 reported cases in which the diseases occurred simultaneo usly. We compare the features of these cases with those of Hodgkin's l ymphoma and SLE occurring alone. Results. Mediastinal adenopathy was s een in 58% and retroperitonial adenopathy in 17% of patients with SLE/ HL, while it was seen only rarely in these sites in cases with SLE. Se vere generalized pruritus, which occurs in only 2.8% of cases of SLE, was seen in 63% of cases with SLE/HL. Features such as fever, weight l oss, peripheral lymphadenopathy, splenomegaly and hepatomegaly are com mon to both Hodgkin's lymphoma and SLE. Renal disease is seen in half of the cases of SLE. It is rare in Hodgkin's lymphoma where, unlike SL E, it is only of minimal change or membranous type. Arthritis and posi tive antinuclear antibodies are rare in Hodgkin's lymphoma. Conclusion s. Persistent lymphadenopathy, especially mediastinal and/or retroperi toneal lymphadenopathy, eosinophilia and generalized pruritus in a pat ient with SLE not responding to treatment may be indicative of coexist ent Hodgkin's lymphoma.