Refractory Hypoglycemia in T-Cell Lymphoma

Case Report

Austin Oncol Case Rep. 2016; 1(1): 1003.

Refractory Hypoglycemia in T-Cell Lymphoma

Buyukaydina B¹*, Tunca M¹, Alayb M², Kazanciogluc R³ and Reha E³

¹Bezmialem Vakif University, Department of Internal Medicine, Turkey

²Yuzuncu Yil University, Department of Endocrinology, Turkey

³Bezmialem Vakif University, Department of Nephology, Turkey

*Corresponding author: Banu Buyukaydin, Bezmialem Vakif University, Department of Internal Medicine, Turkey

Received: June 01, 2016; Accepted: July 10, 2016; Published: July 13, 2016


Hypoglycemia is commonly seen in diabetes mellitus patients; whereas it is rarely seen in a healthy person. In this case, we reported a male patient with a treatment-resistant hypoglycemia. A 53 years old male patient admitted to our clinic with debility, nausea and vomiting. Physical examination revealed lymphadenopathies in the left axilla and inguinal regions; and presence of right upper quadrant tenderness. Biochemical results revealed severe hypoglycemia, azotemia and elevation of liver enzymes. Histological result of the excisional lymph node biopsy was compatible with peripheral T cell lymphoma. In ward, the patient has repeated recurrent hypoglycemia, which did not resolve with all treatment given. His general condition deteriorated and he died due to sepsis. This case highlighted the need to rule out hematologic malignancies; precisely T-cell lymphoma in a patient who presented with resistant hypoglycemia in the presence of lymphadenopathy.

Keywords: Hypoglycemia, Lymphoma, IGF-II


Hypoglycemia is defined as the occurrence of a variety of symptoms in association with plasma glucose concentration of 50mg/dl or less. Oral or parenteral glucose replacement is generally sufficient to provide normal levels. But in patients with resistance to this treatment, refractory hypoglycemia is mentioned.

Peripheral T-cell lymphoma is an aggressive Non-Hodgkin lymphoma that develops from T-cells in different stages of maturity and generally effects people over 60 years of age [1].

We presented a male patient followed with refractory hypoglycemia and finally diagnosed as T-cell lymphoma.

Case Presentation

A 53 years old male patient with an unknown medical illness presented with lethargy, debility, nausea and vomiting for two weeks. He was nonsmoker; never consumed alcohol and never had use addictive drug. Clinical examination was unremarkable except for multiple lymph node enlargement at the axillary and inguinal area; and presence of tenderness at the right upper quadrant of the abdomen.

The patients’ initial laboratory results are presented in (Table 1).

Citation: Buyukaydina B, Tunca M, Alayb M, Kazanciogluc R and Reha E. Refractory Hypoglycemia in T-Cell Lymphoma. Austin Oncol Case Rep. 2016; 1(1): 1003.