Hypercalcemia as a rare manifestation of immune reconstitution inflammatory syndrome (IRIS) in a person living with Human Immunodeficiency Virus (HIV) with disseminated nontuberculous mycobacteriosis
© 2024. The Author(s)..
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. 18Fluoro-D-glucose positron emission computed tomography (18FDG-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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Infection - (2024) vom: 23. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Webendoerfer, Maximilian [VerfasserIn] |
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| Links: |
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| Themen: |
Acute kidney damage |
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| Anmerkungen: |
Date Revised 24.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s15010-024-02228-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370114043 |
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| 245 | 1 | 0 | |a Hypercalcemia as a rare manifestation of immune reconstitution inflammatory syndrome (IRIS) in a person living with Human Immunodeficiency Virus (HIV) with disseminated nontuberculous mycobacteriosis |
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| 500 | |a Date Revised 24.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a 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) | ||
| 520 | |a 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. 18Fluoro-D-glucose positron emission computed tomography (18FDG-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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Mycobacterium avium-intracellulare | |
| 650 | 4 | |a Acute kidney damage | |
| 650 | 4 | |a DLBCL | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a Hypercalcemia | |
| 650 | 4 | |a IRIS | |
| 700 | 1 | |a Konik, Margarethe |e verfasserin |4 aut | |
| 700 | 1 | |a Zettler, Markus |e verfasserin |4 aut | |
| 700 | 1 | |a Wienker, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Rawitzer, Josefine |e verfasserin |4 aut | |
| 700 | 1 | |a Esser, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Kehrmann, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Herrmann, Ken |e verfasserin |4 aut | |
| 700 | 1 | |a Reinhardt, Hans Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Witzke, Oliver |e verfasserin |4 aut | |
| 700 | 1 | |a Dolff, Sebastian |e verfasserin |4 aut | |
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