A paradox: sarcoidosis in an HIV-positive patient

In view of the diminished number of CD4+ lymphocytes, the co-existence of an HIV infection and sarcoidosis seems paradoxical. Immune reconstitution inflammatory syndrome (IRIS) may be observed in response to anti-retroviral therapy (ART). According to the conventional definition, this is caused by a...

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Bibliographic Details
Published inNederlands tijdschrift voor geneeskunde Vol. 159; p. A8353
Main Authors van Kan, Coen, Peringa, Jan, Walter, Armin W, Frissen, P H J Jos, Bresser, Paul
Format Journal Article
LanguageDutch
Published Netherlands 2015
Subjects
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
HIV Infections - epidemiology
HIV Infections - immunology
Humans
Immune Reconstitution Inflammatory Syndrome - epidemiology
Male
Middle Aged
Sarcoidosis - epidemiology
Sarcoidosis - immunology
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Summary:In view of the diminished number of CD4+ lymphocytes, the co-existence of an HIV infection and sarcoidosis seems paradoxical. Immune reconstitution inflammatory syndrome (IRIS) may be observed in response to anti-retroviral therapy (ART). According to the conventional definition, this is caused by an overwhelming immune response to an already present or to a new agent. We describe the case of a 47-year-old HIV-positive patient, who presented with an exacerbation of his sarcoidosis nine months after initiation of ART. Based on the time course and the dynamics of the CD4+ lymphocyte count, this presentation of disease can be placed in the context of IRIS. The presentation or exacerbation of sarcoidosis after initiation of antiretroviral therapy in HIV-positive patients with a low CD4+ count at start of therapy can be placed in the context of IRIS.
ISSN:0028-2162
1876-8784