Immune thrombocytopenia as a rare initial manifestation and complication of Hodgkin lymphoma: a Pediatric case report

Hodgkin lymphoma (HL) is a malignancy of the lymphatic system often associated with immune dysfunction. This case describes an 11-year-old boy presenting with epistaxis, petechiae, and thrombocytopenia (40 000/μl), initially diagnosed as immune thrombocytopenia (ITP). Further evaluation revealed lymphadenopathy and splenomegaly. A biopsy of an axillary lymph node confirmed HL, with immunohistochemical analysis identifying Reed-Sternberg cells positive for CD30 and CD15. The patient began treatment with the ABVD chemotherapy regimen, resulting in significant clinical and hematological improvement. While ITP is commonly associated with autoimmune and lymphoproliferative disorders, its occurrence as a secondary complication of HL is rare, reported in less than 1% of cases. This case emphasizes the importance of considering HL as an underlying cause in patients presenting with unexplained ITP, particularly when lymphadenopathy or systemic symptoms are observed. Prompt diagnosis and initiation of therapy are crucial for achieving positive outcomes in such cases.