ABSTRACT
PURPOSE: We discuss an unusual clinical presentation of Hodgkin disease with immune thrombocytopenia and autoimmune hemolytic anemia. PATIENTS AND METHODS: A 4-year-old boy presented to us with a large anterior mediastinal mass, thrombocytopenia, and Coombs' positive hemolytic anemia refractory to transfusion therapy. Biopsy of the anterior mediastinal mass was possible only after administration of intravenous immunoglobulin to raise the platelet count. The immune manifestations decreased with initiation of appropriate chemotherapy. RESULT: The child was able to successfully complete chemotherapy and radiation therapy and has no clinical or laboratory evidence of persistent autoimmune phenomena. CONCLUSION: Immune thrombocytopenia with autoimmune hemolytic anaemia is a rare presenting manifestation of Hodgkin disease and can present difficulty in diagnosis and management.