Medical illustrations showing the connection between Crohn's and Hodgkin's lymphoma, highlighting the lymphatic system and digestive systemShare on Pinterest
Medical Illustration by Whitney Williams

Does having Crohn’s disease increase the risk of getting Hodgkin’s lymphoma?

In this article, we talk about how Crohn’s disease can make your body vulnerable to Hodgkin’s lymphoma and other infections.

Crohn’s disease is an inflammatory bowel disease (IBD) that causes chronic inflammation of your gastrointestinal (GI) tract. This disease can affect any of the organs making up your GI tract: mouth, esophagus, stomach, intestines, and anus.

It mostly affects the areas where your small and large intestines meet. The kinds of symptoms that show up depend on which part of your GI tract is affected.

Lymphoma is a type of cancer that starts in the white blood cells. There are two types of lymphoma: Hodgkin’s lymphoma and non-Hodgkin’s lymphoma.

Hodgkin’s lymphoma can start wherever there are lymphocytes. These are white blood cells that make antibodies that protect you from germs, bacteria, or viruses. Hodgkin’s lymphoma commonly starts on the chest, neck, and under the arms.

There’s limited knowledge on the connection between Crohn’s disease and Hodgkin’s lymphoma. However, studies done so far show that having Crohn’s disease may increase the risk of getting Hodgkin’s lymphoma.

In a 2018 case study, a 30-year-old man with Crohn’s disease received corticosteroids (a type of steroid) and azathioprine as part of his treatment. These medications, which treat the symptoms of Crohn’s disease but don’t cure the condition, work by limiting the immune system’s activity and reducing inflammation or the severity of any other symptoms.

The man in the study experienced fever and a decline in his general condition while taking his prescribed medications. After some tests, he received a diagnosis of Hodgkin’s lymphoma.

These medications prescribed for Crohn’s disease have been shown to increase the risk of lymphoma. This is mainly because they can lower your white blood cell count or your immune system’s activity, increasing your vulnerability to infection.

This observation was supported by a 2017 study that showed the risk of getting Hodgkin’s lymphoma was five times higher in individuals who used immunosuppressants to treat their Crohn’s disease.

If immunosuppressants and steroids don’t improve your symptoms, your doctor may put you on biologic medications. Unlike other medications that are produced from chemical processes, this treatment is made biologically from organisms such as living cells.

Biologics may reduce your immune system’s activity. Some types bind themselves to a protein called tumor necrosis factor-alpha (TNF-alpha), produced in response to an infection or injury. By binding themselves to this protein, these biologics block it from causing inflammation.

Since biologics also suppress your immunity, the chances of getting an infection can increase when you’re taking this type of medication.

Anti-TNF medications, such as infliximab, have also been shown to increase the chance of getting lymphoma. The risk is higher when you use this medication and take another immunosuppressant simultaneously.

Generally, having Crohn’s disease can make you vulnerable to getting Hodgkin’s lymphoma, especially if you’re on immunosuppressive therapy. Thiopurines are the most commonly prescribed immunosuppressant.

There are other factors that can increase your chances of getting Hodgkin’s lymphoma, such as infection by Epstein-Barr virus (EBV). Your doctor may order EBV serological tests as a regular screening.

There’s also a 2020 study showing that those who have Crohn’s disease are more likely to get primary intestinal Hodgkin’s lymphoma, a type of cancer that develops in the GI tract.

According to the American Cancer Society, you can have Hodgkin’s lymphoma without experiencing any discomfort.

Still, it can be helpful to familiarize yourself with the symptoms so you can consult your doctor as soon as possible. Besides unexplained fever, other symptoms include:

  • a lump in your neck, groin, or your arm
  • appetite loss
  • night sweats
  • unintentional weight loss
  • fatigue

When you’ve got Crohn’s disease, you’re likely to experience any of these symptoms, too. That’s why you’ll need to keep your doctor updated on your condition.

Yes, your lymph nodes may swell if you’ve got Crohn’s disease. This is known as lymphadenopathy.

Lymph nodes contain white blood cells that help you fight off infections. When an infection occurs in the areas of your body where lymph nodes are present, white blood cells and the fluid containing these cells, known as lymph, will accumulate in those areas. This causes lymph nodes to swell.

When your lymph nodes swell, their size may vary. Regardless of the size, it can feel tender or painful if you touch them or when you make certain movements.

The lymphatic system is part of the immune system. It’s made up of organs and tissues such as lymph nodes, spleen, and vessels. It carries white blood cells that your body needs to fight disease and infections.

Cancer or inflammatory diseases like Crohn’s disease can affect the function of the lymphatic system. When this happens, lymph can build up and swelling occurs. This can in turn reduce the lymph flow significantly.

According to a 2021 study, such changes to the lymphatic system can affect your body’s ability to repel infections and diseases.

If you experience any of the symptoms discussed above, talk with your doctor as soon as possible. It will be very helpful to monitor your conditions and keep them updated regularly.

Inform your doctor immediately if you develop any signs of infection, such as fever or cramps, while taking any prescribed medication.