A Case of Kaposi's Sarcoma Following Treatment of Membranoproliferative Glomerulonephritis and a Review of the Literature

Ağbaht, Kemal; Pepedil, Funda; Kırkpantur, Alper; Yılmaz, Rahmi; Arıcı, Mustafa; Turgan, Çetin

doi:10.1080/08860220601039551

Cited by 10 publications

(10 citation statements)

References 26 publications

(26 reference statements)

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“…Our study has shown four-fold odds of Kaposi's sarcoma-related mortality in individuals receiving glucocorticoids, after controlling for possible confounding factors. Glucocorticoid therapy has also been clinically associated with development of Kaposi's sarcoma in non-HIV-related diseases such as transplant recipients [ 14 , 15 ]; rheumatic disorders [ 16 , 17 ]; asthma [ 18 ]; lung cancer [ 19 ]; dermatologic diseases [ 20 , 21 ]; atopic dermatitis [ 22 ]; ulcerative colitis [ 23 ]; glomerulonephritis [ 24 , 25 ] and many other clinical conditions of iatrogenic immunosuppression. In most cases, withdrawal of immunosuppressive therapies leads to Kaposi's sarcoma remission, but not in the case of HIV-infected individuals [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection

Fernández-Sánchez

Iglesias

Ablanedo-Terrazas

et al. 2016

Aids

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Objectives:To investigate the association between Kaposi's sarcoma-associated immune reconstitution inflammatory syndrome (KS-IRIS) and mortality, with the use of glucocorticoids in HIV-infected individuals.Design:Case–control study.Methods:We reviewed the medical records of 145 individuals with HIV-associated Kaposi's sarcoma receiving antiretroviral therapy. The association of different variables with KS-IRIS and Kaposi's sarcoma-related mortality was explored by univariate and multivariate analyses. The main exposure of interest was the use of glucocorticoids. We also compared the time to KS-IRIS and the time to death of individuals treated with glucocorticoids vs. those nontreated with glucocorticoids, and the time to death of individuals with KS-IRIS vs. those without KS-IRIS by hazards regression.Results:Sixty of 145 individuals received glucocorticoids (41.4%) for the management or suspicion of Pneumocystis jirovecii pneumonia. Fifty individuals had KS-IRIS (37%). The use of glucocorticoids was more frequent in individuals with KS-IRIS than in those without KS-IRIS (54.9 vs. 36.47%, P = 0.047). Kaposi's sarcoma-related mortality occurred in 17 cases (11.7%), and glucocorticoid use was more frequent in this group (76.47 vs. 36.7%, P = 0.003). Glucocorticoid use was a risk factor for mortality (adjusted odds ratio = 4.719, 95% confidence interval = 1.383–16.103, P = 0.0132), and was associated with shorter periods to KS-IRIS (P = 0.03) and death (P = 0.0073). KS-IRIS was a risk factor for mortality (P = 0.049).Conclusion:In HIV-infected individuals, the use of glucocorticoids is a risk factor for KS-IRIS and Kaposi's sarcoma-associated mortality. In addition, KS-IRIS is a risk factor for mortality. Therefore, glucocorticoid administration in this population requires careful consideration based on individualized risk–benefit analysis.

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Section: Discussionmentioning

confidence: 99%

Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection

Fernández-Sánchez

Iglesias

Ablanedo-Terrazas

et al. 2016

Aids

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“…Persons with chronic renal failure are at risk of developing HHV8-related diseases, and KS is a rare complication of glomerular diseases (Agbaht et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

et al. 2009

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BACKGROUND: Little information is available on the causes of death among persons with classic Kaposi's sarcoma (CKS). METHODS: We conducted a population-based study in Italy to identify deceased persons with CKS and the underlying causes of death among them, by reviewing multiple-causes-of-death records. Standardised mortality ratios (SMRs) and 95% confidence intervals were calculated to compare the distribution of causes to that among the same-age general population of deceased persons. The geographical distribution was also evaluated. RESULTS: Of the 946 deaths among persons with CKS, 65.9% were attributable to non-neoplastic conditions and 21.9% to malignancies. For 12.2%, no lethal pathology was identified and CKS was considered as the underlying cause. In 90% of these cases, there was visceral/nodal involvement, therapy-related complications, or neoplastic cachexia. Among persons with CKS who died of other causes, an excess for lymphoid malignancies emerged (SMR ¼ 4.40) (chronic lymphocytic leukaemia (11.03), non-Hodgkin's lymphoma (4.22), Hodgkin's lymphoma (11.80), and multiple myeloma (2.3)), balanced by a deficit for all solid cancers (0.56), with a marked deficit for lung cancer (0.41). We found an excess for respiratory diseases (chronic obstructive pulmonary disease (1.86)) and genitourinary diseases (chronic renal failure (6.47)). There was marked geographical heterogeneity in the distribution of deaths. CONCLUSIONS: Though referring specifically to Italy, the results are informative for other countries and populations and all cases of CKS in general.

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“…KS has been rarely reported to be associated with glomerulonephritis with and without the use of immunosuppressive therapy. [8][9][10][11][12] The mechanism of pathogenesis is thought to be reactivation of latent HHV-8 infection. The underlying kidney disease has no role in development of KS as it was seen in different diseases such as membranoproliferative, focal glomerulosclerosis, as well as membranous glomerulonephritis.…”

Section: Discussionmentioning

confidence: 99%

“…It was also seen in the usage of cyclophosphamide and azathioprin. 12 In these cases, the patients usually develop a cutaneous KS. In contrast to that, our patient unusually developed a tonsillar tumor.…”

Section: Discussionmentioning

confidence: 99%

Tonsillar Kaposi Sarcoma in a Patient with Membranous Glomerulonephritis on Immunosuppressive Therapy

et al. 2013

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Kaposi sarcoma is a malignant vascular neoplasm uncommonly seen in immunosuppressed patients. Herein we report an unusual case of tonsillar Kaposi sarcoma in a patient with membranous glomerulonephritis treated with prednisolone and cyclosporine. The patient presented after 10 months of starting the treatment with a tonsillar mass. Histological examination was typical of monomorphic spindle cell proliferation with slit-like vascular channels. The tumor cells expressed CD34, D2-40 and positive nuclear stain for HHV-8. Kaposi sarcoma is associated with immunosuppression and rarely occurs in the tonsil. Clinicians should be aware of this rare presentation of Kaposi sarcoma.

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A Case of Kaposi's Sarcoma Following Treatment of Membranoproliferative Glomerulonephritis and a Review of the Literature

Cited by 10 publications

References 26 publications

Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection

Steroids are a risk factor for Kaposi's sarcoma-immune reconstitution inflammatory syndrome and mortality in HIV infection

Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995–2002)

Tonsillar Kaposi Sarcoma in a Patient with Membranous Glomerulonephritis on Immunosuppressive Therapy

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