Hypotension associated with advanced Hodgkin lymphoma

  • Ankit Mangla | ankit.mangla.md@gmail.com Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United States.
  • Geetanjali Dang Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United States.
  • Hussein Hamad Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United States.
  • Roozbeh Mohajer Division of Hematology and Oncology, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United States.
  • Rosalind Catchatourian Division of Hematology and Oncology, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United States.
  • Paula Kovarik Department of Pathology, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, United States.

Abstract

Hypotension is an extremely rare manifestation of Hodgkin lymphoma. We report the case of a patient who presented with new onset hypotension and was diagnosed with urosepsis and septic shock requiring pressor support for maintaining his blood pressure. computed tomography (CT) scan of abdomen showed liver lesions, which were new on comparison with a CT abdomen done 3 weeks back. Biopsy of the liver lesions and subsequently a bone marrow biopsy showed large atypical Reed-Sternberg cells, positive for CD15 and CD 30 and negative for CD45, CD3 and CD20 on immunohistochemical staining, hence establishing the diagnosis of Hodgkin lymphoma. The mechanism involved in Hodgkin lymphoma causing hypotension remains anecdotal, but since it is mostly seen in patients with advanced Hodgkin lymphoma, it is hypothetically related to a complex interaction between cytokines and mediators of vasodilatation. Here we review relevant literature pertaining to presentation and pathogenesis of this elusive and rare association.

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Published
2014-09-29
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Issue
Section
Case Reports
Keywords:
Hodgkin lymphoma, hypotension, liver metastasis
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How to Cite
Mangla, A., Dang, G., Hamad, H., Mohajer, R., Catchatourian, R., & Kovarik, P. (2014). Hypotension associated with advanced Hodgkin lymphoma. Hematology Reports, 6(3). https://doi.org/10.4081/hr.2014.5572