A 64-year-old woman with a history of epilepsy, neurocysticercosis, ischemic vascular accident, peptic ulcer and cholecystectomy 5 years prior to admission.
She suffered from mental illness, choluria, acholia, anorexia and significant weight loss during the last month, with no other discomfort.
On physical examination a marked tenderness of the skin with inguinal lymphadenopathy was evident.
Laboratory tests revealed anemia (hemoglobin 7.2 g/dl), elevation of direct transaminase (GrubOT 286 U/L, probinin 4 mg/L), normal renal function (total serum albumin, 1886 mg/dl), hypercholesterolemia (1.420 seconds).
Biliary tract study was performed with ultrasound, endoscopic retrograde cholangiography, and magnetic resonance imaging that ruled out possible intrinsic obstruction.
Abdominal computed tomography showed hepatomegaly and multiple intra-abdominal and inguinal lymphadenopathies of nonspecific aspect.
Biopsy of the inguinal ganglion and bone marrow classic type Hodgkin's lymphoma, mixed cellularity variety, with positivity for CD30 and CD15, and absence of CD20 in the cells concluded.
Considering his hepatic insufficiency and hepatotoxicity of the conventional schemes, treatment was started with corticosteroids and then with CHOP total glycamide (UL63 bilirubin), admicillin, vincristine, prednisone (GOT) 2 mg,
Two episodes of E. coli sepsis were successfully treated as a complication.
Finally, an effective decrease in bilirubin levels (total 1.73 mg/dl, direct 1.26 mg/dl) was achieved, allowing the use of standard therapy (BADL).
Currently, 75 days after the end of the last cycle of GDP, there is the chronic condition, attending the second cycle of BADL, showing good tolerance.
The laboratory shows moderate anaemia (a 9.1 g/dl), lower elevation of transaminase (GOT (90 U/L), lower elevation of transaminase (GOT (90 U/L), normal alkaline phosphatase (PTU/dl), and direct bilirubin (698 U/dl),
