A Rare Case of Burkitt’s Lymphoma Presenting with Features Mimicking Vogt Koyanagi Harada Disease (921)

Objective: We report a case of Burkitt’s lymphoma in an HIV positive patient presenting with features suggestive of Vogt Koyanagi Harada disease (VKHD). We describe a rare presentation of lymphoma that would prevent misdiagnosis and promote early recognition. Background: A 25-year-old male initially presented with right eye pain and blurry vision. He was found to have bilateral serous retinal detachments and was diagnosed with VKHD and started on prednisone. He stopped taking the prednisone, and his vision worsened. He then developed right eye ptosis, restricted eye movements, nausea, vomiting, headache, dysphagia, tongue deviation, and slurred speech. MRI showed diffuse cranial nerve enhancement. He was found to be positive for HIV and Hepatitis A with CD4 count of 41. Lumbar puncture showed WBC 83 (94% lymphocytes), RBC 1460, glucose 62, and protein 195, with EBV positivity and negative cytology. Gd1a antibody was positive (72). He underwent empiric treatment with IV methylprednisolone for possible VKHD exacerbation, followed by empiric IVIG for possible AIDP. He subsequently developed diffuse limb weakness and loss of reflexes, and he was treated with PLEX. He demonstrated minimal response to treatment. EMG was unrevealing, and MRI of the cervical and lumbar spine showed diffuse nerve root thickening and enhancement. He underwent an EGD for continued dysphagia, and biopsy was positive for an aggressive B cell lymphoma strongly favoring Burkitt’s lymphoma. Design/Methods: NA Results: NA Conclusions: VKHD is a rare condition diagnosed based on retinal exam findings. There have been anecdotal reports of lymphoma cases that present with symptoms of VKHD. To our knowledge, this is the first case of lymphoma initially presenting with these retinal findings. Understanding this potential presentation of lymphoma is essential for early diagnosis and treatment and for optimizing patient outcomes. Disclosure: Dr. Tadipatri has nothing to disclose. Dr. Gonzalez has nothing to disclose. Dr. Muley has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with CSL Behring, Alexion, Speakers Bureau, Takeda.