Hypercalcemic crisis due to adult T cell leukemia: a rare cause of paralytic ileus.
Adult T cell leukemia- lymphoma is a rare aggressive malignancy of the peripheral T lymphocytes, caused by human T cell lymphotropic virus -1 (HTLV-1) infection. Hypercalcemia occurs in about 70% of patients with acute adult T cell leukemia. However, there are very few case reports of adult T cell leukemia presenting as a hypercalcemic crisis. We report a case of a 54-year-old male who presented with abdominal pain, constipation and altered sensorium. On examination he had generalized lymphadenopathy, hepatosplenomegaly and paralytic ileus. Investigation revealed hypercalcemic crisis with low parathormone (PTH) levels. Peripheral smear and bone marrow aspirate were consistent with adult T cell leukemia. HTLV-1 serology was positive. Despite the corrective measures for hypercalcemia and chemotherapy, he succumbed to the illness in a week.
Department of Medical Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala, India.
Sojan George
SG
Kunnathuparambil
Department of Medical Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala, India.
Pradeep Kumar
PK
Payangappadom
Department of Medical Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala, India.
Praveen Kumar
PK
Yerol
Department of Medical Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala, India.
Mukunda
M
Madhavan
Department of Medical Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala, India.
Sreejaya
S
Sreesh
Department of Medical Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala, India.
Premaletha
P
Narayanan
Department of Medical Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala, India.
Krishnadas
K
Devdas
Department of Medical Gastroenterology, Government Medical College, Thiruvananthapuram, Kerala, India.
Vinayakumar
V
Ramakrishanan Kattoor
adult T cell leukemia; human T cell lymphotropic virus (HTLV) -1; hypercalcemic crisis; paralytic ileus