[Transverse myelitis revealing Hodgkin disease].
BACKGROUND
Neurological complications during Hodgkin disease are rare and sometimes difficult to diagnose. We report the case of a patient with transverse myelitis.


METHODS
This 32-year-old man was hospitalized on month after onset of febrile spastic paraplegia, which was accompanied by progressive deterioration of his general condition. Examination revealed a febrile, conscious patient, with abolition of the lower-limb tendon reflexes, bilateral Babinski signs, and sensitivity at D6-D7. We also noted hepatosplenomegaly, but no peripheral adenopathies. Laboratory reports indicated bicytopenia, a major inflammatory syndrome and hepatic cytolysis. The computed tomography examination of thorax and abdomen showed swelling in deep lymph nodes and the brain MRI showed what appeared to be transverse myelitis. The brainstem biopsy was normal; the hepatic biopsy showed liver infiltration by Sternberg cells. The patient died rapidly, before treatment could begin.


CONCLUSIONS
The variable neurological events observed during Hodgkin disease may serve to reveal this disease. Their association with a tumor suggests this diagnosis even when the neurological signs are nonspecific. They may affect either the brain or the brainstem. Diagnostic certainty requires histologic analysis, and prognosis depends on early diagnosis and management.
Kilani
Badreddine
B
Service des Maladies Infectieuses, EPS La Rabta, 1007, Tunis. badreddine.kilani@rns.tn
Ammari
Lamia
L
Tiouiri
Hanène
H
Kanoun
Fakher
F
Ben Romdhane
Khaled
K
Ben Chaabane
Taoufik
T
D000328:Adult; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006689:Hodgkin Disease / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009188:Myelitis, Transverse / Q000150:complications* / Q000473:pathology*; D014057:Tomography, X-Ray Computed