Primary Plasma Cell Leukaemia in a Young HIV Infected Male, Associated with Epstein-barr Virus

Background: Primary Plasma Cell Leukaemia (PPCL) in young patients has been evaluated in very few studies in the English literature. The aim of this study is to describe a case of PPCL in a young HIV infected male associated with EBV. This is first such case in Indian literature. This is an interesting study that reported a rare case where primary plasma cell leukaemia is observed in a young HIV infected male, which will be valuable case for future studies. Thorough clinical examinations were done and reported in detail.

Methods: A 35 years old male presented with abdominal pain, backache and asthenia. A thorough workup was done including clinical examination, CBP, KFT, LFT, serology (HIV, HBsAg), Serum electrophoresis, radiology and bone marrow examination. A systematic literature review was conducted by searching the Pub Med and National Centre for Biotechnology Information database.

Results: Patient had hepatosplenomegaly and icterus. Peripheral smear revealed atypical plasma cells (53%). Serum protein electrophoresis showed a monoclonal IgG-K paraprotein at a concentration of 4.56 (45 g/l) (Ref- 0.10-0.40). Patient had hypoalbuminemia and raised liver enzymes. The serology test for HIV was reactive for HIV-I and II. Bone marrow examination showed hypercellularity with near replacement of the normal marrow elements by sheets of mature plasma cells and a few immature plasma cells. Plasma cells were EBER positive. Based on the overall findings, a diagnosis of PPCL was made and subsequently, the patient was referred for chemotherapy.

Conclusion: To our knowledge PPCL in HIV infected young male associated with EBV has not been previously reported in the Indian literature. Given the rare incidence of this entity in the general population, it is very unlikely that they occurred by chance. Further research is needed to determine what would be the optimal management options of such patients.