Chylous ascites in disseminated Kaposi sarcoma: an unusual manifestation as immune reconstitution inflammatory syndrome
| Autor: | Inês Nabais, Ana Rafaela Alves, Nuno Melo, Patrícia Cipriano |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Abdominal pain Pleural effusion HIV Infections Gastroenterology Thoracic duct Polyethylene Glycols Diagnosis Differential Sexual and Gender Minorities 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Immune reconstitution inflammatory syndrome Immune Reconstitution Inflammatory Syndrome Antiretroviral Therapy Highly Active Chylous ascites Internal medicine Ascites medicine Humans Chylous Ascites Sarcoma Kaposi Unusual Presentation of More Common Disease/Injury business.industry Chylothorax General Medicine Prognosis medicine.disease 030112 virology medicine.anatomical_structure Doxorubicin Sarcoma medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| DOI: | 10.1136/bcr-2018-228406 |
| Popis: | A 29-year-old man with diarrhoea, fever, abdominal pain and multiple purple papular lesions, neither pruriginous nor painful, was diagnosed with HIV-1 infection and disseminated Kaposi sarcoma (KS) with gastrointestinal involvement. He was started on highly active antiretroviral therapy immediately, as well as doxorubicin. Three weeks later, the patient developed bilateral moderate pleural effusion and large-volume ascites compatible with chylothorax and chylous ascites. An immune reconstitution inflammatory syndrome (IRIS) reaction was assumed. KS flare was associated with lymphatic obstruction and infiltration of thoracic duct by the tumour itself with leakage of chylous into pleural and peritoneal cavities. KS is the most common tumour in HIV patients and the existence of related effusions is not uncommon. KS-related chylothorax is an unusual manifestation of KS; there are only four cases described in the literature of chylous ascites related to KS–HIV. Overall survival is improving in KS but explosive and debilitating IRIS reactions can explain cases with poor prognosis. |
| Databáze: | OpenAIRE |
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