Kaposi's sarcoma revealing an immune restoration syndrome

Mamoudou Savadogo; Ismaël Diallo

doi:10.30574/gscarr.2021.7.1.0082

Authors

Mamoudou Savadogo Department of Infectious Diseases, CHU Yalgado Ouédraogo, Burkina Faso.
Ismaël Diallo Department of Internal Medicine, Yalgado Ouédraogo, Burkina Faso.

DOI:

https://doi.org/10.30574/gscarr.2021.7.1.0082

Keywords:

Immune restoration syndrome, Kaposi's, HIV, Antiretroviral therapy

Abstract

Introduction: Highly active antiretroviral therapy (HAART) leads to reconstitution of immune responses in HIV-infected patients. This immune reconstitution may reveal an immune reconstitution syndrome (IRS). While tuberculosis is the most common manifestation of IRS in southern countries, other more serious conditions such as Kaposi's disease may reveal it.

Observation: We report a case of Kaposi's disease revealing an immune restoration syndrome with the aim of contributing to a better management. The patient was 38 years old and HIV1 positive, severely immunocompromised with a TCD4 lymphocyte count of 138 cells/mm3. He was admitted to the YO University Hospital for fever associated with a progressive deterioration of the general condition. On admission, he showed signs of anemic cardiomyopathy (functional systolic murmur + edema of the lower limbs + severe anemia at 4.7g/dl) and signs of functional renal failure (creatinine=182 micromol/l). Under treatment, the evolution was favorable and he was discharged from the hospital on antiretroviral treatment (ARV). Three months after the start of ARV treatment, the follow-up assessment noted an increase in TCD4 lymphocytes to 300 cells/mm3 and the skin examination revealed Kaposi's lesions on the thigh. With specific treatment, the evolution was favorable.

Conclusion: Early detection and management of HIV infection can prevent some serious manifestations of immune restoration syndrome, such as Kaposi's disease.

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References

Silvia S, Claire R, Anne B. Le syndrome inflammatoire de reconstitution immunitaire: plusieurs visages pour le même syndrome. Méd. 2015; 21(1): 8-18.

Kassi A, Kouassi I, Mossou C, Koui S, Kouakou G, Doumbia A, Aba T, Eholié S, Kakou A, Bissagnené E. Maladie de Kaposi associé au traitement antirétroviral chez un patient infecté par le VIH à Abidjan. Premier cas. Rev int sci Med Abj. 2014; 16: 168-171.

Breton G. Syndrome inflammatoire de reconstitution immune. Bull. Acad. Natle Méd. 2011; 195: 561-575.

Ndiaye B, Kane A.La maladie de Kaposi africaine: spécificités cliniques et épidémiologiques. Objectif Peau. 1997; 5(35): 380-383.

Ndiaye Maodo, Diop Assane, Berthe Siritio, Diallo Moussa, Mjahed Sara, Diatta Boubacar.Ahy, Diadie Saer, Seck Ndeye.Bougoul, diallo Salimatou, Ndiaye Mame.Tene, Niang Suzanne.Oumou, Ly Fatimata, Dieng Mame.Thierno, Kane Assane. Maladie de kaposi endémique à Dakar: étude de 29 cas. Mali Méd. 2014; 29(4).

Christeff N, Winter C, Gharakhanian S, Thobie N, Costagliola D.Differences in androgens of HIV positive patients with and without Kaposi’s sarcoma. J Clin Pathol. 1995; 48(6): 513-518.

Griffet P, Soudre R, Ouattara H. La maladie de Kaposi: à propos du premier cas décrit au Burkina Faso = Kaposi sarcoma: Study of the first case in Burkina-Faso. Méd. Afr. Noire. 1986; (33): 647-648.

Breton G. Syndrome inflammatoire de reconstitution immune. Bull. Acad. Natle Méd. 2011; 195: 561-575.

Bihl F, Mosam A, Henry LN et al. Kaposi’s sarcoma-associated herpesvirus-specific immune reconstitution and antiviral effect of combined HAART/chemotherapy in HIV clade C-infected individuals with Kaposi’s sarcoma. AIDS. 2007; 21: 1245-1252.

Paparizos VA, Kyriakis KP, Papastamopoulos V, Hadjivassiliou M, Stavrianeas NG. Response of AIDSassociated Kaposi sarcoma to highly active antiretroviral therapy alone. J Acquir Immune Defic Syndr 2002; 30: 257-8.