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Caspian J Intern Med. 2019 Winter;10(1):111-117. doi: 10.22088/cjim.10.1.111.

Hypocalcemia Revealing an Enteropathy-Associated T-cell Lymphoma.

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Department of Internal Medicine, Gran Canaria University Hospital, Las Palmas, Spain.
Department of Internal Medicine, Chretien Hospital, Liege, Belgium.
Department of Internal Medicine, Yeovil District Hospital, Yeovil, United Kingdom.
Department of Internal Medicine. Bourguiba University Hospital Fattouma, Monastir, Tunisia.
Department of Internal Medicine, San Carlos University Hospital, Madrid, Spain.



Enteropathy-associated T-cell lymphoma (EATL) is a rare and aggressive type of extranodal T-cell lymphoma (TCL) arising in the gastrointestinal (GI) tract and represents 5-8% of all T-cell non-Hodgkin lymphomas (NHL) and 10-25% of primary intestinal lymphomas.

Case presentation:

We reported a 78-year-old woman presenting with severe hypocalcemia. Investigations confirmed vitamin D and iron deficiency as well as hypoalbuminemia. Celiac disease was suspected and confirmed, but despite intravenous calcium and magnesium supplementation and a gluten-free diet, normal electrolyte levels were never reached. Intestinal perforation was the clue to the diagnosis of enteropathy-associated T-cell lymphoma (EATL).


Hypocalcemia can result from multiple conditions. In patients not responding to adequate supplementation, further investigations should be performed to diagnose the underlying condition.


Celiac disease; Enteropathy-associated T-cell lymphoma; Hypocalcemia; Hypomagnesemia

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