Hodgkin´s Lymphoma and Autoimmunity: Is There a Relationship?

Introduction: The relationship between lymphomas and autoimmune diseases has been reported as bi-directional, however there is a few data in pediatric population. The aim of this work is to evaluate the prevalence of autoimmune diseases in children and adolescents with Hodgkin´s lymphoma followed in a Pediatric Oncology Unit. Material and Methods: By reviewing Hodgkin’s lymphomas data from the past 16 years (collected prospectively), an apparently large incidence of autoimmune diseases, mostly in female patients, was noted. We decided to do this retrospective study with an update on follow-up. Data analyzed: age, gender, autoimmune disease, temporal relation with lymphoma, lymphoma´s stage, histologic subtype and treatment. Results: Fifty-two cases were included, 7 (13.5%) of which, all female, had an autoimmune disease diagnosed previously, simultaneously or after lymphoma. Autoimmune diseases were: juvenile idiopathic arthritis, inflammatory bowel disease, Behçet´s disease, autoimmune hepatitis, systemic erythematosus lupus, Hashimoto´s thyroiditis and idiopathic thrombocytopenic purpura. The diagnosis was made after lymphoma in 4 patients, before in 2 and simultaneously in 1 patient. All cases, except the one with simultaneous diagnosis, are out of treatment and without oncologic disease relapse. No deaths were registered. Discussion: There was an important prevalence of autoimmune diseases in girls with Hodgkin´s lymphoma. We present data and discuss the possible causes based on a literature review. Conclusions: This relationship should be invoked, requiring more studies, especially in pediatric age.