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Hypercalcemia as a rare manifestation of immune reconstitution inflammatory syndrome (IRIS) in a person living with Human Immunodeficiency Virus (HIV) with disseminated nontuberculous mycobacteriosis.
- Source :
- Infection; Aug2024, Vol. 52 Issue 4, p1627-1631, 5p
- Publication Year :
- 2024
-
Abstract
- 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. <superscript>18</superscript>Fluoro-D-glucose positron emission computed tomography (<superscript>18</superscript>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. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV infection complications
MYCOBACTERIAL disease diagnosis
MYCOBACTERIAL diseases
WEIGHT loss
ETHAMBUTOL
BIOPSY
ANTIRETROVIRAL agents
DIPHOSPHONATES
RARE diseases
IMMUNE reconstitution inflammatory syndrome
HIV-positive persons
HYPERCALCEMIA
HIV infections
POSITRON emission tomography computed tomography
ACUTE kidney failure
CALCITONIN
MUSCLE weakness
CALCITRIOL
ANTI-infective agents
CALCIUM
CLARITHROMYCIN
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 03008126
- Volume :
- 52
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Infection
- Publication Type :
- Academic Journal
- Accession number :
- 178774653
- Full Text :
- https://doi.org/10.1007/s15010-024-02228-7