Pulmonary Kaposi sarcoma with osseous metastases in an human immunodeficiency virus (HIV) patient: A remarkable response to highly active antiretroviral therapy

Ahmed Dirweesh, Muhammad Yasir Khan, Shaikh Fawad Hamiz, Nigahus Karabulut

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: Rare disease Background: Kaposi sarcoma (KS) is known to involve the mucocutaneous tissues and the aero-digestive tracts. In acquired immune deficiency syndrome (AIDS) patients, KS has an aggressive course and carries poor prognosis. We present a case of pulmonary KS with osseous metastases as the first presentation of human immunodeficiency virus (HIV) infection in a young male. The lesions impressively decreased in size and numbers following initiation of highly active antiretroviral therapy (HAART). Case Report: A 34-year-old heterosexual male presented with a one month history of cough and 15–20 pound weight loss within six months. Examination revealed oral thrush, decreased breath sounds and crackles on the right lower lung base. Imaging showed a large right perihilar mass with multiple lytic lesions involving thoracic and lumber vertebrae, ribs, sternum, and clavicles. Blood and sputum cultures, smears for acid fast bacilli, and a QUANTIferon gold test were all negative. He tested positive for HIV and his CD4 count was 7 cells/uL. Bronchoscopy with biopsy was unrevealing. Pathology of the right hilar mass was diagnostic of KS. Following initiation of antiretroviral therapy his condition dramatically improved; repeat chest CT scan showed marked regression of the bony and pulmonary lesions. Conclusions: The dual action of HAART on the recovery of the immune system and against human herpes virus 8 (HHV-8) may essentially cause regression of KS lesions.

Original languageEnglish (US)
Article number902355
Pages (from-to)181-185
Number of pages5
JournalAmerican Journal of Case Reports
Volume18
DOIs
StatePublished - Feb 20 2017

Keywords

  • AIDS serodiagnosis
  • Anti-HIV agents
  • HIV
  • Sarcoma, Kaposi

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