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Paraneoplastic MCD Hodgkin — ESENeph MCQ

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ModerateGlomerulonephritisParaneoplastic MCD HodgkinESENeph

A 30-year-old woman presents with nephrotic syndrome. She has a history of Hodgkin lymphoma treated 5 years ago and is in remission. Biopsy shows minimal change disease. What is the association?

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Correct answer: E — Minimal change disease is a recognised paraneoplastic association with Hodgkin lymphoma

MCD is the most commonly associated paraneoplastic glomerular disease with Hodgkin lymphoma. The mechanism involves tumour-derived cytokines (particularly IL-13) causing podocyte dysfunction. It can occur at diagnosis, during relapse, or even after apparent remission. Treatment is with corticosteroids as for primary MCD, but lymphoma surveillance is essential. If MCD relapses, lymphoma recurrence should be considered and investigated.

Reference: KDIGO 2021 – GN Guideline; Jhaveri et al 2013 – Paraneoplastic GN