Paraneoplastic Inflammatory Arthritis

Abstract

The immunodeficiency virus infection is known to increase the risk of malignancies, including lymphomas. We report a case of a 51-year-old male with a history of human immunodeficiency virus (HIV) infection, well-controlled on antiretroviral treatment, who presented with polyarthritis and hypercalcemia due to an elevated parathyroid-hormone-related peptide. Computer tomography (CT) revealed diffuse lymphadenopathy and a lymph node biopsy revealed large B-cell lymphoma. He was treated and responded well to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy regimen. Our case highlights the importance of recognizing inflammatory arthritis as an initial manifestation of occult malignancy like large B-cell lymphoma, as the arthritis preceded his eventual diagnosis of lymphoma by several months.