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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.

Author information

1
Department of Internal Medicine, Gran Canaria University Hospital, Las Palmas, Spain.
2
Department of Internal Medicine, Chretien Hospital, Liege, Belgium.
3
Department of Internal Medicine, Yeovil District Hospital, Yeovil, United Kingdom.
4
Department of Internal Medicine. Bourguiba University Hospital Fattouma, Monastir, Tunisia.
5
Department of Internal Medicine, San Carlos University Hospital, Madrid, Spain.

Abstract

Background:

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).

Conclusion:

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

KEYWORDS:

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

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