Diffuse Large B-Cell Lymphoma Presenting with Diabetes Insipidus: A Case Report

Kaur, Arvinder; Thomas, Asha

doi:10.4158/ep14295.cr

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…Kaur et al reported an HIV-PCNSL case with involvement of the hypothalamus, pituitary, and paranasal sinuses, marked by central diabetes insipidus. Multidrug chemotherapy with "EPOCH-R" (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) and intravenous methotrexate yielded neurological improvement after treatment (15). Bello et al presented a case of HIV-PCNSL with a space-occupying lesion extending into the suprasellar spaces, causing hypothalamic compression.…”

Section: Discussionmentioning

confidence: 99%

Hypoglycemia and leg weakness in a patient with acquired immunodeficiency syndrome (AIDS): a case report

Tsai,

Bai,

Hsieh

et al. 2024

Preprint

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Background: Acquired immunodeficiency syndrome (AIDS), stemming from human immunodeficiency virus (HIV) infection, persists as a global concern, despite decreased prevalence due to enhanced therapy and preventive measures. Primary central nervous system lymphoma (PCNSL), a non-Hodgkin lymphoma, necessitates prompt brain imaging. However, nonspecific symptoms can lead to delayed diagnosis. Herein, we present a case of HIV-associated primary CNS lymphoma (HIV-PCNSL) characterized by atypical clinical presentation and laboratory findings. Case presentation: We report a case of a 36-year-old male with no medical history presenting with symptoms including fatigue, left leg weakness, hypoglycemia, and loss of consciousness. Diagnostic evaluations revealed multifocal low-density brain changes and the presence of nontyphoidal Salmonella in blood cultures. Subsequent investigations confirmed acquired immunodeficiency syndrome (AIDS) with concurrent human immunodeficiency virus (HIV) infection. Clinical manifestations and laboratory results suggested panhypopituitarism. A stereotactic brain biopsy confirmed primary central nervous system lymphoma (PCNSL). The patient underwent a comprehensive treatment regimen involving Rituximab and high-dose methotrexate for lymphoma, highly active antiretroviral therapy (HAART) for HIV, and hormone replacement therapy for secondary adrenal insufficiency. This integrated approach resulted in tumor size reduction and overall clinical improvement. Conclusions: AIDS may manifest with diverse symptoms, particularly when neurological deficits are evident, prompting consideration of opportunistic brain infections or malignancies. Our case presentation elucidates the clinical rationale and diagnostic trajectory for detecting AIDS in a young man with hypoglycemia and left leg weakness. This underscores not only the atypical manifestations and differential diagnosis of brain lesions in AIDS patients but also advocates for a comprehensive approach.

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Section: Discussionmentioning

confidence: 99%

Hypoglycemia and leg weakness in a patient with acquired immunodeficiency syndrome (AIDS): a case report

Tsai,

Bai,

Hsieh

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The latter had a similar clinical presentation as the reported case regarding hypopituitarism and DI; however, our patient was younger (age, 29 vs 53 years) and had a worse virulogic control. In immunocompetent patients, the age of presentation also usually is more advanced, isolated diabetes insipidus is more common, tumor size is smaller and treatment response is more favorable ( 13 ). The case is noteworthy due to the atypical clinical presentation of a CNS lymphoma as diabetes insipidus.…”

Section: Discussionmentioning

confidence: 99%

Diabetes insipidus and hypopituitarism in HIV: an unexpected cause

Bello

Santos

Duarte

et al. 2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Central diabetes insipidus (DI) is a rare clinical entity characterized by low circulating levels of antidiuretic hormone (ADH) presenting with polyuria and volume depletion. Pituitary surgery is the most common cause of central DI in adults. Pituitary and hypothalamic disease, particularly invasive neoplasms, rarely cause DI, being idiopathic cases responsible for the majority of non-surgical cases. HIV patients, especially those with poor virulogical control, are prone to the development of CNS neoplasms, particularly lymphomas. These neoplasms usually become manifest with mass effects and seizures. Central DI and hypopituitarism are uncommon initial manifestations of primary CNS lymphomas. The authors describe the case of 29-year-old female, HIV-positive patient whose CNS lymphoma presented with DI.Learning points:Central diabetes insipidus has multiple causes and central nervous system lymphomas are not often considered in the differential diagnosis due to their low prevalence.Accurate biochemical diagnosis should always be followed by etiological investigation.The HIV population is at risk for many neoplasms, especially CNS lymphomas.New-onset polyuria in an HIV-positive patient in the absence of focal neurological signs should raise the suspicion for a central nervous system process of neoplastic nature.This clinical entity usually constitutes a therapeutical challenge, often requiring a multidisciplinary approach for optimal outcome.

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Diffuse Large B-Cell Lymphoma Presenting with Diabetes Insipidus: A Case Report

Cited by 2 publications

References 11 publications

Hypoglycemia and leg weakness in a patient with acquired immunodeficiency syndrome (AIDS): a case report

Hypoglycemia and leg weakness in a patient with acquired immunodeficiency syndrome (AIDS): a case report

Diabetes insipidus and hypopituitarism in HIV: an unexpected cause

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