RESUMO
In childhood acute lymphoblastic leukaemia [ALL], the eye would represent a pharmacological sanctuary, source of unexpected relapse. Three boys aged of 13 years, 4 and 5 years presented after the complete remission, a lymphoblastic relapse in the anterior segment of the eyes in the first two cases, and in the posterior segment of the left eye in the third case. The treatment was a systemic chemotherapy and orbital radiotherapy of 12 Gray. The patients died after they experienced bone marrow and/or central nervous system relapses within the first year. The outlook for children with ocular relapse remains poor. Only radiotherapy doses superior then 30 Gray can eradicate lymphoblastic cells and improve the prognosis
RESUMO
Hodgkin's disease can be associated to autoimmune disorders including autoimmune hemolytic anemia. This association is rare. We report a Hodgkin's disease revealed by haemolytic anaemia in two children. Case 1: a 13 year-old boy presented acute hemolysis one month before with abdominal lymph nodes. The Coombs test and IgG were positive. In spite of corticosteroid therapy during two months, the hemolysis has persisted. Abdominal lymph nodes biopsy was achieved. This biopsy revealed a Hodgkin's disease. The chemotherapy has permitted a complete remission of the Hodgkin's disease and the cure of hemolysis. The follow-up is 27 months. Case 2: a 11 year-old girl presented an hemolytic anemia two months before. She had an abdominal mass and a splenomegaly. The Coombs test and IgG were positives. The abdominal mass biopsy diagnosed a Hodgkin's disease. The chemotherapy cured the hemolysis. The Hodgkin's disease was in complete remission after a follow-up of 26 months. This patient developed a vitiligo in the beginning of the treatment. Hodgkin's disease is a possible diagnosis when auto-immune hemolytic anemia is associated with lymphoproliferative syndrome, and only chemotherapy can stop the hemolysis