HTLV-1-associated Adult T Cell Leukemia Lymphoma Presenting As Granulomatous Pneumocystis Jiroveci Pneumonia (PJP) and Hypercalcemia

Overview

Journal J Gen Intern Med

Publisher Springer

Specialty General Medicine

Date 2007 Mar 16

PMID 17356979

Citations 9

Authors

Sabiha Shahnaz

David Reich

Diana Arevalo-Valencia

Slavka Kucinska

Joanna Tulczynska

Jean Fleischman

Affiliations

Soon will be listed here.

Abstract

Background: Since the initial description of human T cell lymphotropic virus (HTLV-1), clusters of this infection have been detected globally. Unlike HIV infection, most patients infected with HTLV-1 remain asymptomatic throughout their lifetime.

Case Report: We report the case of a 39-year-old Afro-Caribbean man with HTLV-1 infection presenting as hypercalcemia and granulomatous pneumocystis jiroveci pneumonia.

Results: Interestingly, the hypercalcemia presented with normal parathyroid hormone-related protein and low 1,25 dihydroxyvitamin D levels, and the presence of pneumocystis jiroveci in the granulomas was diagnosed with transbronchial biopsy taken during bronchoscopy. HTLV-1-associated adult T cell leukemia lymphoma (ATLL) was diagnosed in this patient by bone marrow and lymph node biopsy.

Conclusion: Increased bone resorption, likely cytokine-mediated, is the most likely mechanism of hypercalcemia in this patient. This is believed to be the first description of this type of reaction to pneumocystis jiroveci in a HTLV-1-infected ATLL patient.

Citing Articles

Adult T-cell leukemia/lymphoma complicated by pneumonia in a non-endemic area.

Kunimoto M, Inomata M, Chin H, Ito Y, Fujimoto K, Muto Y Respir Med Case Rep. 2023; 42:101807.

PMID: 36660069 PMC: 9843483. DOI: 10.1016/j.rmcr.2023.101807.

Cryobiopsy for pneumonia secondary to adult T-cell lymphoma/leukaemia.

Kobe H, Saito K, Arita M, Ishida T Respirol Case Rep. 2022; 10(1):e0893.

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pneumonitis: cause of acute hypercalcaemia in chronic haemodialysis patient.

Garo F, Aglae C, Ahmadpoor P, Moranne O BMJ Case Rep. 2020; 13(1).

PMID: 31988055 PMC: 7021179. DOI: 10.1136/bcr-2019-231334.

Severe hypercalcemia preceding a diagnosis of Pneumocystis jirovecii pneumonia in a liver transplant recipient.

Yau A, Farouk S BMC Infect Dis. 2019; 19(1):739.

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Diversity of cell phenotypes among MT-2 cell lines affects the growth of U937 cells and cytokine production.

Nomura H, Umekita K, Hashikura Y, Umeki K, Yamamoto I, Aratake Y Hum Cell. 2018; 32(2):185-192.

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