Hickam's Dictum prevails: navigating the maze of dual pathology in HIV
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...
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| Language: | en |
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Federation of Islamic Medical Associations (FIMA)
2023
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| Online Access: | http://irep.iium.edu.my/110871/2/110871_Hickam%27s%20Dictum%20prevails.pdf http://irep.iium.edu.my/110871/ https://www.ijhhsfimaweb.info/index.php/IJHHS/article/view/601 http://dx.doi.org/10.31344/ijhhs.v7i7000.601 |
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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
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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. |
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