Hypercalcemia-Induced Altered Mental Status as the Primary Manifestation of Classic Hodgkin Lymphoma

    April 2020 in “ Journal of the Endocrine Society ”
    Taher Modarressi, Megha K. Shah
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    TLDR An 87-year-old man showed unusual signs of Hodgkin lymphoma, primarily high calcium levels, which improved after treatment and revealed the disease.
    In 2020, a case study was presented of an 87-year-old man who was admitted to a medical institution with symptoms of severe hypercalcemia, including increased agitation and confusion. This was an unusual presentation as hypercalcemia is not commonly the primary symptom in Hodgkin lymphoma (HL) cases. The patient's laboratory evaluation revealed a serum calcium level of 17.5 mg/dL and serum creatinine 3.0 mg/dL. After treatment with intravenous fluids and pamidronate, his calcium levels improved. A bone marrow biopsy revealed the presence of classic Hodgkin lymphoma. The patient was then treated with a regimen of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine, which resulted in an excellent clinical response. This case highlighted an atypical, hypercalcemia-driven initial presentation of Hodgkin’s lymphoma.
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