DOI: 10.12890/2015_00251

Lymphadenopathy after Initiating HAART in an HIV-positive Patient with Kaposi's Sarcoma: a Case of Multicentric Castleman's Disease

Authors

  • Daniel Micallef Department of Medicine, Mater Dei Hospital, Msida
  • Jason Attard Department of Pathology, Mater Dei Hospital, Msida
  • Charles Mallia Azzopardi Department of Medicine, Mater Dei Hospital, Msida
  • Michael John Boffa Department of Dermatology, Sir Paul Boffa Hospital, Floriana

daniel.b.micallef@gov.mt

Keywords

Castleman's disease, Kaposi's sarcoma, immune reconstitution inflammatory syndrome

Abstract

We present the case of a 33-year-old lady who was diagnosed with disseminated Kaposi’s sarcoma and HIV infection. The patient improved on highly active antiretroviral therapy (HAART), however, nine days into treatment, she became febrile and dyspnoeic and developed tender cervical and axillary lymphadenopathy. Despite treatment for suspected sepsis and immune reconstitution, she died in intensive care. Lymph node biopsies revealed coexistent Castleman’s disease and Kaposi’s sarcoma.

Initiation of HAART can be rarely associated with unmasking and rapid progression of Castleman’s disease, a phenomenon called immune reconstitution. Urgent investigation and treatment with agents such as steroids and cytotoxic drugs can be life-saving.

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References

  1. Hengge UR, Ruzicka T, Tyring SK, Stuchke M, Roggendorf M, Schwartz RA, et al. Update on Kaposi’s sarcoma and other HHV8 associated diseases. Part 1: epidemiology, environmental predispositions, clinical manifestations, and therapy. Lancet Infect Dis 2002;2:281–292.
  2. Saeed-Abdul-Rahman I, Al-Amri AM. Castleman disease. Korean J Hematol 2012;47:163–177.
  3. Perales I, Muiiez E, Espert I, Ramos A, Martin T. Impact of HAART in HIV patients with multicentric Castleman’s disease. Eur J Intern Med 2003;14:S1–S159.
  4. Zietz C, Bogner JR, Goebel FD, Löhrs U. An unusual cluster of cases of Castleman’s disease during highly active antiretroviral therapy for AIDS. N Engl J Med 1999;3401923–1924.
  5. Bower M. How I treat HIV-associated multicentric Castleman disease. Blood 2010;116:4415–4421.

Published

2015-10-07

Issue

Vol. 2 No. 7 (2015)

How to Cite

1.
Micallef D, Attard J, Mallia Azzopardi C, Boffa MJ. Lymphadenopathy after Initiating HAART in an HIV-positive Patient with Kaposi’s Sarcoma: a Case of Multicentric Castleman’s Disease. EJCRIM [Internet]. 2015 Oct. 7 [cited 2026 Nov. 3];2(7). Available from: https://ejcrim.com/index.php/ejcrim/article/view/251

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