[Diffuse large B cell lymphoma with HIV infection presented with disseminated thromboembolism during antiretroviral therapy].

Abstract

Patients with HIV are at higher risk of developing thrombosis than the general population. We present a rare case of a 57-year-old Japanese man with HIV infection and a malignant lymphoma. He had fever with unknown origin and cervical lymph node swelling 2 months before his hospital visit. Because he was positive for the HIV antibody, he was referred to our HIV special outpatient section. HIV RNA level was found to be 846,680 copies/ml. Therefore, antiretroviral therapy of DTG/ABC/3TC was initiated. However, the high fever continued for 7 days after treatment initiation; moreover, renal dysfunction was progressive. After admission, antibiotic therapy was initiated, due to which the fever subsided. However, renal dysfunction continued to progress. Fourteen days later, he died due to acute renal failure with hyperkalemia. An autopsy revealed a large mass in the spleen, and histological findings revealed a diffuse large B cell lymphoma (DLBCL). Furthermore, thrombi were detected in the right and left ventricles, right atrium, iliac artery, and renal artery. Pathological findings revealed that the thrombus induced the renal failure. These thrombi contained fibrin with inflammatory cell infiltration but not tumor cells. Patients with HIV and malignant lymphoma are at a higher risk of thrombosis. It is important to consider thrombosis during the treatment of patients with HIV.

• Authors: Hiroshi Ikeda, Masayoshi Kobune, Kana Nagashima, Chisa Fujita, Akari Goto, Hiroto Horiguchi, Shohei Kikuchi, Kazuyuki Murase, Kohichi Takada, Satoshi Iyama, Junji Kato
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 61 Issue 11 Pg. 1595-1599 ( 2020) ISSN: 0485-1439 [Print] Japan
• PMID: 33298652 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents

Topics

• Antiviral Agents (therapeutic use)
• HIV Infections (complications, drug therapy)
• Humans
• Lymph Nodes
• Lymphoma, Large B-Cell, Diffuse (complications, drug therapy)
• Male
• Middle Aged
• Thromboembolism (etiology)