Severe hypercalcaemia and lymphoma in an HTLV-1 positive Jamaican woman: a case report

Abstract

Human T cell lymphotrophic virus type-1 infection is endemic in the Afro-Caribbean community in Britain, with carriage rates of about 3%. Although there is a long latency, carriers have a 1-5% chance of developing adult T cell leukaemia/lymphoma, a condition frequently complicated by marked and refractory hypercalcaemia, and with a poor prognosis. We present the case of an elderly Jamaican woman with severe hypercalcaemia and a raised PTHrP who was found to have lymphoma and was positive for HTLV-1.

Figure 1

Serum calcium concentration over the course of the admission.

Figure 2

CT of upper abdomen. Extensive lymphadenopathy is noted in the para-aortic area (arrow) and surrounding the superior mesenteric artery. Body wall oedema, ascites and gall bladder sludge reflect the patient's debilitated condition.