Hickam's Dictum prevails: navigating the maze of dual pathology in HIV

Shajahan, Rafiq and Thoulath, Imran and Safiuddin, Rashida and Abd Halim, Ahmad Zuhri Shin and Ishak, Rozilah and Md Pauzi, Suria Hayati and Md Isa, Nurismah and Kok, Wei Hao and Kori, Najma and Zainulabid, Ummu Afeera and Periyasamy, Petrick (2023) Hickam's Dictum prevails: navigating the maze of dual pathology in HIV. International Journal of Human and Health Sciences, 2023 (Supplementary Issue 3). S-214-S-214. ISSN 2523-692X

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Abstract

OPEN JOURNAL SYSTEMS USER Username Password Remember me JOURNAL CONTENT Search Search Scope All Browse By Issue By Author By Title Other Journals INFORMATION For Readers For Authors For Librarians ABOUT THE AUTHORS Rafiq Shajahan Medical Department, Hospital Kuala Lumpur Imran Thoulath Cardiology Department, Institut Jantung Negara Malaysia Rashida Safiuddin Department of Internal Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz Malaysia Ahmad Zuhri Shin Abd Halim Department of Internal Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz Malaysia Rozilah Ishak Department of Internal Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz Malaysia Suria Hayati Md Pauzi Department of Internal Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz Malaysia Nurismah Md Isa Department of Internal Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz Malaysia Wei Hao Kok Department of Internal Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz Malaysia Najma Kori Department of Internal Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz Malaysia Ummu Afeera Zainulabid Department of Internal Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz Malaysia Petrick Periyasamy Department of Internal Medicine, Faculty of Medicine, Hospital Canselor Tuanku Muhriz Malaysia ARTICLE TOOLS Print this article Indexing metadata How to cite item Email this article (Login required) Email the author (Login required) HOME ABOUT LOGIN REGISTER SEARCH CURRENT ARCHIVES Home > 2023 > Shajahan Hickam's Dictum Prevails: Navigating the Maze of Dual Pathology in HIV Rafiq Shajahan, Imran Thoulath, Rashida Safiuddin, Ahmad Zuhri Shin Abd Halim, Rozilah Ishak, Suria Hayati Md Pauzi, Nurismah Md Isa, Wei Hao Kok, Najma Kori, Ummu Afeera Zainulabid, Petrick Periyasamy Abstract In the realm of HIV, considering various causes for clinical presentations is crucial. This case report reveals the exceptional coexistence of advanced neuroendocrine tumor and Burkitt's lymphoma, an infrequently reported combination in an individual with HIV. Emphasizing Hickam's Dictum, which promotes comprehensive exploration of multiple possibilities, rather than settling for a single diagnosis (Occam's razor), we present the intriguing journey of a 44- year-old man with HIV and hepatitis B co-infection. The patient, diagnosed with HIV and hepatitis B in 2017, discontinued antiretroviral therapy and presented to the emergency department with breathlessness. He experienced fever, night sweats, chronic diarrhoea, and a significant weight loss of 15 kg over six months. Physical examination revealed flushed cheeks, hepatomegaly, and other alarming signs. Initial treatment focused on disseminated tuberculosis, but further investigations unveiled heart failure and a pancreatic lesion. The clinical picture suggested neuroendocrine tumor and carcinoid syndrome, supported by elevated serum chromogranin levels. A colonoscopy ruled out gastrointestinal involvement but surprisingly revealed Burkitt's lymphoma. Tragically, the patient succumbed to a carcinoid crisis. This case highlights the importance of considering multiple differentials in HIV-infected individuals, as illustrated by the convergence of neuroendocrine tumor and Burkitt's lymphoma. Previous case reports suggest an unusual link between carcinoid tumours and lymphoreticular malignancies. Neuroendocrine hormones may influence the proliferation and mitogenesis of lymphoid cells that may develop into diseases. Vigilance in recognizing and understanding dual pathology can aid in reducing mortality. Further research is needed to explore potential connections between these rare malignancies.

Item Type:	Article (other)
Uncontrolled Keywords:	HIV; AIDS; neuroendocrine tumour; Burkitt's lymphoma
Subjects:	R Medicine > RC Internal medicine > RC111 Infectious and Parasitic Diseases
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Internal Medicine Kulliyyah of Medicine
Depositing User:	Asst. Dr. Ummu Afeera Zainulabid
Date Deposited:	15 Feb 2024 15:28
Last Modified:	15 Feb 2024 15:28
URI:	http://irep.iium.edu.my/id/eprint/110871

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