Administration of Corticosteroids Is Effective for Hyperactive Delirium Due to Intravascular Large B-cell Lymphoma: A Case Report

Rika Kihara; Yumi Yamazoe; Yasuyuki Asai; Yoshiya Adachi; Kyoko Kuwabara; Masahiko Fujino; Satoru Saburi; Takuya Odagiri; Koichi Watamoto; Hiroaki Watanabe

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Administration of Corticosteroids Is Effective for Hyperactive Delirium Due to Intravascular Large B-cell Lymphoma: A Case Report

VernacularTitle:血管内大細胞型B細胞リンパ腫に伴う過活動型せん妄に対してステロイド投与が有効であった1例
Author: Rika KIHARA ¹ ; Yumi YAMAZOE ² ; Yasuyuki ASAI ¹ ; Yoshiya ADACHI ² ; Kyoko KUWABARA ¹ ; Masahiko FUJINO ³ ; Satoru SABURI ⁴ ; Takuya ODAGIRI ⁵ ; Koichi WATAMOTO ² ; Hiroaki WATANABE ¹
Author Information

1. Department of Hematology, Komaki City Hospital
2. Department of Palliative Care, Komaki City Hospital
3. Department of Diagnostic Pathology, Komaki City Hospital
4. Department of Cytology and Molecular Pathology, Japanese Red Cross Nagoya Daiichi Hospital
5. Department of Psychiatry, Komaki City Hospital
Keywords: Intravascular large B-cell lymphoma; delirium; corticosteroids
From:Palliative Care Research 2020;15(3):199-204
CountryJapan
Language:Japanese
Abstract: Introduction: Intravascular large B-cell lymphoma (IVLBCL) is a rare disease entity of non-Hodgkin lymphoma. Patients with IVLBCL frequently have neurological symptoms associated with cerebrovascular infarction or central nervous system involvement of malignant lymphoma. Case: A 67-year-old man consulted the Department of Hematology at our hospital because of fever of unknown origin, anemia and increased serum lactate dehydrogenase. Although IVLBCL was strongly suspected, no lymphoma cells were found by multiple bone marrow aspirations and skin biopsies. Two months later, he developed hyperactive delirium, which was difficult to manage using antipsychotic agents. Brain MRI revealed multiple hyper-intense infarct-like lesions on diffusion-weighted images. After assessment of bone marrow aspiration and skin biopsies, he was administered an enough dose of prednisolone to manage malignant lymphoma. Hyperactive delirium rapidly improved. Discussion: In patients with IVLBCL, corticosteroids may be useful to manage hyperactive delirium due to cerebrovascular infarction or central nervous system involvement of IVLBCL.