title: Wegener's granulomatosis with antiproteinase-3 antibodies occurring after Hodgkin's disease.
abstract: We describe the first association between Hodgkin's lymphoma and Wegener's granulomatosis, heralded by renal involvement. A 43-year-old man developed rapidly progressive glomerulonephritis requiring chronic hemodialysis 8 months after remission of Hodgkin's lymphoma. At that moment, no extrarenal involvement was found, despite extensive investigation. Antineutrophil cytoplasm antibodies were positive, without specificity for proteinase-3 or myeloperoxydase. Six months after beginning hemodialysis, multiple pulmonary nodules appeared, along with rapid clinical worsening. A surgical biopsy was performed which disclosed a giant cell granuloma. Antimyeloperoxydase antibodies remained negative, whereas proteinase-3 antibodies became positive. Wegener's granulomatosis was diagnosed and treatment with cyclophosphamide and steroids was started. Clinical and radiological improvement occurred promptly. Eleven months after treatment, both Wegener's disease and Hodgkin's lymphoma remained in remission.
authors.affiliation: Department of Nephrology, Hôpital Edouard-Herriot, Bron, France.
authors.forename: P
authors.initials: P
authors.lastname: Gratadour
authors.forename: D
authors.initials: D
authors.lastname: Fouque
authors.forename: M
authors.initials: M
authors.lastname: Laville
authors.forename: J
authors.initials: J
authors.lastname: Fourcade
authors.forename: M
authors.initials: M
authors.lastname: Ffrench
authors.forename: S
authors.initials: S
authors.lastname: Colon
authors.forename: F
authors.initials: F
authors.lastname: Berger
authors.forename: R
authors.initials: R
authors.lastname: Loire
authors.forename: J F
authors.initials: JF
authors.lastname: Cordier
authors.forename: P
authors.initials: P
authors.lastname: Zech
mesh_terms: D000328:Adult; D000906:Antibodies / Q000032:analysis*; D014890:Granulomatosis with Polyangiitis / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D006689:Hodgkin Disease / Q000150:complications / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000276:immunology / Q000473:pathology; D007678:Kidney Glomerulus / Q000473:pathology; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D053146:Myeloblastin; D006435:Renal Dialysis; D012697:Serine Endopeptidases / Q000276:immunology*; D014057:Tomography, X-Ray Computed
chemical_list: D000906:Antibodies; D012697:Serine Endopeptidases; D053146:Myeloblastin