Subacute sensory neuropathy associated with Hodgkin's disease

Abstract

We describe 2 patients with Hodgkin's disease (HD) who developed a subacute predominantly sensory neuropathy with areflexia, which improved after tumour removal, and review 6 cases with sensory neuropathies associated with HD from the literature. The neuropathy revealed a relapse of the tumour in patient 1 and was the presenting feature of HD with Castleman's disease-like lesions in patient 2. Nerve conduction velocities were normal, sensory and motor potential amplitudes were reduced, and F waves were increased. Unlike sensory ganglionitis associated with small cell lung cancer, sensory evoked potentials were not abolished. Nerve biopsies showed axonal degeneration and mild perivascular inflammatory infiltrates. We believe that the cases of subacute sensory neuropathies associated with HD that show dramatic improvement after treatment of the underlying tumour correspond to a variant of HD-associated inflammatory demyelinating polyneuropathy rather than to a true paraneoplastic sensory ganglionitis.