A Case of Lymphoma in HIV Positive Patient

Dr Pawan S. Chandak

Name: Mr. Babasaheb Dukre

Age: 50 years/M

Occupation: Farmer

Date of Consultation: May 10, 2011

Chief Complaints

  • Early greying of hairswith swelling on both sides ofthe cervical region
  • He is K/C/O HIV and is on anti-retroviral treatment since 2008

On Examination

Swelling is taut, immovable with no redness and is not warm to touch. Right-sided swelling is larger about 6–7cm and left-sided swelling measures 4–5 cm approx. The swelling is painless with no tendency to suppuration and is not bothering his daily routine.

On further enquiry,the patient told that he had reported the swelling at ART Centre on April 28, 2011 and they started AKT with no results.

Glimpses of Lab Investigations

  • Hb – 12.9 gm%
  • TLC – 7000/cmm
  • DLC

Neutrophils:64/cmm

Lymphocytes: 35/cmm

Eosinophils: 01/cmm

Monocytes:00/cmm

Basophils:00/cmm

  • ESR – 16 mm/hr
  • Blood Sugar Random – 86mg/dl
  • RFT showed Serum Urea – 36 mg/dl
  • Sr. Creatinine – 0.9 mg/dl

TRIDOT: Reactive for HIV I Infection

CD4 Count: 296 (Before Treatment)

CD3 Count: 953 (Before Treatment)

Montoux Test: Positive (more than 15 mm erythema)

Dept of Tuberculosis & Dept of ART Centre diagnosed it as ‘Lymphoma’.

Normal range of CD4 count should be 354 - 1100 /ul
Normal range of CD3 count should be 716 - 2130/ul as per values given by Ranbaxy report & NACO.

Generalities

  • Appearance:Robust person, wheatish complexion with sturdy voice
  • Weight: 60 Kg
  • Appetite: Decreased
  • Dietary habits: Vegetarian
  • Thirst: Average; 1glass/hr
  • Craving: Sweets++, Sour++
  • Aversion: None
  • Sleep: Normally sleeps for 7-8hours with blanket covering up to neck
  • Thermals

Bathing: Warm water whole year

Covering: Thin covering whole year

Fanning: Seasonal

Thermal Reaction: Chilly

  • Natural Eliminations

Bowels: Normal; once a day daily, soft stool

Urine: Pale, profuse, no particular odour

Perspiration: Generalized on exertion, no staining

Photograph (Before Treatment)

General Examination

  • Temperature: 98.6o F
  • Respiratory Rate: 25/min
  • Pulse: 90/min
  • Tongue: Clean and moist
  • Teeth & Gums: Healthy
  • Skin & Hair: Wheatish, healthy; no pallor, icterus, cyanosis and clubbing

Basis of Prescription:

Non suppurating Glandular swelling.

Lymphoma.

Glandular Remedy

Prescription

Phytolacca 30, 4 pills, three times a day for one month

Follow Up

Date / Complaints / Prescription
June 9, 2011 / Swelling bursted and cleared off from left side. Slight pain. No discharge. No scar.
The patient was advised to investigate for CD4 & CD3 count:
CD4 – 523 andCD3 – 1626
On right side as it i / Phytolacca 30, four pills, TDS, for 1 month
8/7/2011 / Left side clear.
Right sided swelling decreased in size. / Phytolacca 30, four pills, TDS, for 1 month.
1/8/2011 / Right sided swelling decreased to quarter of its original size. / Phytolacca 30, four pills, TDS, for 1 month.
1/9/2011 / Right sided swelling burst and cleared off. Slight discharge & scar.
Investigation for CD3 & CD4 says:
CD3–579,CD4-1675 / Phytolacca 30, four pills, Twice a Day, for 1 month.

Discussion:

The patient had responded well to the pathological prescription and quickly relieved by the most similimum. Phytolocca has affinity over tonsils, lymphatics and breast . Many cases with proliferative and indurative pathologies respond to the homoeopathic treatment.

DR Pawan S Chandak BHMS
Homoeopathic Physician & Chief Editor
'Modern Homoeopathy' E-Newsletter
'Shradha' Vishnu Nagar,
Basmat Road, Parbhani 431401, Maharashtra