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CC BY 4.0 · Indian J Med Paediatr Oncol 2024; 45(01): 080-082
DOI: 10.1055/s-0043-1770926
Case Report with Review of Literature

A Case Report and Literature Review of Primary Central Nervous System Lymphoma in a Patient with Crigler–Najjar Syndrome: How We Managed

Udip Maheshwari
1   Medical Oncology Department, Mumbai Oncocare Centre, Mumbai, Maharashtra, India
,
Disha Morzaria 
1   Medical Oncology Department, Mumbai Oncocare Centre, Mumbai, Maharashtra, India
,
Seema Jagiasi
1   Medical Oncology Department, Mumbai Oncocare Centre, Mumbai, Maharashtra, India
,
Vashishth Maniar
1   Medical Oncology Department, Mumbai Oncocare Centre, Mumbai, Maharashtra, India
,
Ashish Joshi
1   Medical Oncology Department, Mumbai Oncocare Centre, Mumbai, Maharashtra, India
,
Sameer Soneji
2   Infinity Scan Centre, Mumbai, Maharashtra, India
› Author Affiliations Funding None declared.
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Abstract

Primary central nervous system lymphoma (PCNSL) is a rare form of CNS tumor that can be managed with curative intent using high-dose chemotherapeutic drugs. High-dose methotrexate is an essential drug for the management of PCNSL. We present a case of a 26-year-old man with a known comorbidity of Crigler–Najjar syndrome type II and a baseline bilirubin of 13.5 mg/dL, presented with somnolence and ataxia. In view of hyperbilirubinemia, the optimal treatment for CNS lymphoma, the De Angelis protocol, was modified for this patient. The patient tolerated the chemotherapy well with manageable fluctuations in bilirubin levels, followed by consolidation with whole-brain radiotherapy. He remains asymptomatic 6 months after the onset of the symptoms with the disease in complete remission. We highlight here this unusual case of PCNSL where high-dose methotrexate was used with close observation of liver function in view of hyperbilirubinemia in a known case of Crigler–Najjar syndrome.

Keywords

Crigler–Najjar syndrome - DeAngelis protocol - hyperbilirubinemia - primary CNS lymphoma

Patient's Consent

Informed consent was obtained from all individual participants included in the study.




Publication History

Article published online:
22 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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