Hypercalcemia as a rare manifestation of immune reconstitution inflammatory syndrome (IRIS) in a person living with Human Immunodeficiency Virus (HIV) with disseminated nontuberculous mycobacteriosis.

Autor: Webendoerfer M; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany. maximilian.webendoerfer@uk-essen.de.; Department of Infectious Diseases, West German Center of Infectious Diseases, Essen University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany. maximilian.webendoerfer@uk-essen.de., Konik M; Department of Infectious Diseases, West German Center of Infectious Diseases, Essen University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany., Zettler M; Department of Infectious Diseases, West German Center of Infectious Diseases, Essen University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany., Wienker J; Department of Pneumology, University Hospital Essen - Ruhrlandklinik, University of Duisburg-Essen, Tüschener Weg 40, 45239, Essen, Germany., Rawitzer J; Institute for Pathology and Neuropathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany., Esser S; Department of Dermatology and Venereology, HIV Outpatient Clinic, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany., Kehrmann J; Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany., Herrmann K; Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany., Reinhardt HC; Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany., Witzke O; Department of Infectious Diseases, West German Center of Infectious Diseases, Essen University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany., Dolff S; Department of Infectious Diseases, West German Center of Infectious Diseases, Essen University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Jazyk: angličtina
Zdroj: Infection [Infection] 2024 Aug; Vol. 52 (4), pp. 1627-1631. Date of Electronic Publication: 2024 Mar 23.
DOI: 10.1007/s15010-024-02228-7
Abstrakt: Introduction: Granulomatosis due to immune reconstitution inflammatory syndrome (IRIS) and disseminated Mycobacterium avium-intracellulare (M. avium) infection may trigger hypercalcemia. Here, we report a rare case of hypercalcemia and acute kidney damage related to IRIS in a person living with Human Immunodeficiency Virus (HIV).
Case Presentation: A 39-year-old male person living with HIV presented with muscle weakness and unwanted weight loss of 8 kg within the last 2 weeks. Laboratory findings included serum hypercalcemia of 3.27 mmol/mL associated with elevated calcitriol and acute kidney damage. Since the first diagnosis of HIV and concomitant disseminated M. avium infection, the patient received antiretroviral therapy (ART), rifabutin, clarithromycin, and ethambutol. 18 Fluoro-D-glucose positron emission computed tomography ( 18 FDG-PET/CT) showed progressive multilocular lymphadenopathy. Biopsy specimen from the duodenum as well as retroperitoneal and mediastinal lymph nodes revealed granulomatous inflammation consistent with IRIS. Treatment with forced diuresis, bisphosphonates, and calcitonin normalized serum calcium and kidney function recovered.
Conclusion: Hypercalcemia due to IRIS is a rare differential diagnosis in persons living with HIV and may lead to acute kidney damage, despite sufficient ART and antimycobacterial treatment.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: