Bilateral Chylothorax. An Unusual Presentation in the Course of Immune Reconstitution Inflammatory Syndrome, HIV Infection and Kaposi’s Sarcoma: A Case Report

Boultadakis,

doi:10.4021/jmc1630w

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…Our search of previous literature on PubMed revealed only 18 cases, among which 17 were HIV-positive patients and one was an HIV-negative patient; 13 had chylothorax, 2 had chylous ascites, and 3 had both. After treatment, 6 patients survived while 12 died, resulting in a mortality rate of approximately 66.7% (Table 1) [4][5][6][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. * The two patients labeled as 'likely HIV positive' came from case reports published in 1986 and 1988, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Cherian et al depicted a case of chylothorax in an HIV-associated KS patient that showed improvement after four months of systemic chemotherapy, a medium chain triglyceride (MCT) diet, percutaneous chest tube drainage, and talc pleurodesis treatment [10]. A review of the literature reveals that, apart from symptomatic supportive therapy, all patients with Kaposi's sarcoma who developed chylous effusions and had a favorable prognosis received timely systemic chemotherapy [10,12,14,[20][21][22]. In our case, the patient also achieved a positive outcome after being treated with chemotherapy in addition to antiretroviral therapy and local symptomatic treatment.…”

Section: Discussionmentioning

confidence: 99%

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Chylothorax and Chylous Ascites in AIDS-Associated Kaposi's Sarcoma： A Case Report and Literature Review

Jiang,

Peng,

Zhang

et al. 2024

Preprint

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Background: Kaposi's sarcoma (KS) is one of the most common tumors in patients with AIDS, while the occurrence of chylous effusions in Kaposi's sarcoma patients is rare and often indicates a poor prognosis. This report presents a case of successful management of an AIDS patient with Kaposi's sarcoma who developed both chylothorax and chylous ascites, along with a review of the relevant literature. Case presentation: A 31-year-old male patient, who was recently diagnosed with HIV infection and oral Kaposi's sarcoma at our clinic center, returned two weeks post-discharge. He reported significant enlargement of the oral tumor, increased abdominal girth with accompanying abdominal distension and pain, and a dry cough over the past week. Upon readmission, CT scans indicated the presence of extensive pleural and abdominal effusions. Aspirates from both the pleural and abdominal effusions exhibited a milky chylous appearance. After eliminating other potential etiologies for the chylous effusion, we associated it with the progression of Kaposi's sarcoma. The patient's condition was ultimately successfully managed through a combination of antiretroviral therapy, systemic chemotherapy, and intermittent thoracoabdominal paracentesis for drainage. Conclusion: The emergence of chylothorax and chylous ascites should arouse suspicion of Kaposi's sarcoma, and the presence of chylous effusions in Kaposi's sarcoma patients is an indication of disease progression. Prompt diagnosis and systemic treatment are crucial for the prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Chylothorax and Chylous Ascites in AIDS-Associated Kaposi's Sarcoma： A Case Report and Literature Review

Jiang,

Peng,

Zhang

et al. 2024

Preprint

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“…KS-related chylothorax is described by a few authors as an unusual manifestation of KS,16–19 one of which also in context of IRIS 18. This could be explained due to metastatic KS in the thoracic duct and adjacent mediastinal structures, to in situ KS in the thoracic region20 or, probably, due to the negative intrathoracic pressure of the thorax, which drew ascitic fluid into the pleural space.…”

Section: Discussionmentioning

confidence: 99%

Chylous ascites in disseminated Kaposi sarcoma: an unusual manifestation as immune reconstitution inflammatory syndrome

Cipriano

Nabais²,

Melo³

et al. 2019

BMJ Case Rep

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A 29-year-old man with diarrhoea, fever, abdominal pain and multiple purple papular lesions, neither pruriginous nor painful, was diagnosed with HIV-1 infection and disseminated Kaposi sarcoma (KS) with gastrointestinal involvement. He was started on highly active antiretroviral therapy immediately, as well as doxorubicin. Three weeks later, the patient developed bilateral moderate pleural effusion and large-volume ascites compatible with chylothorax and chylous ascites. An immune reconstitution inflammatory syndrome (IRIS) reaction was assumed. KS flare was associated with lymphatic obstruction and infiltration of thoracic duct by the tumour itself with leakage of chylous into pleural and peritoneal cavities. KS is the most common tumour in HIV patients and the existence of related effusions is not uncommon. KS-related chylothorax is an unusual manifestation of KS; there are only four cases described in the literature of chylous ascites related to KS–HIV. Overall survival is improving in KS but explosive and debilitating IRIS reactions can explain cases with poor prognosis.

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Bilateral Chylothorax. An Unusual Presentation in the Course of Immune Reconstitution Inflammatory Syndrome, HIV Infection and Kaposi’s Sarcoma: A Case Report

Cited by 2 publications

References 12 publications

Chylothorax and Chylous Ascites in AIDS-Associated Kaposi's Sarcoma： A Case Report and Literature Review

Chylothorax and Chylous Ascites in AIDS-Associated Kaposi's Sarcoma： A Case Report and Literature Review

Chylous ascites in disseminated Kaposi sarcoma: an unusual manifestation as immune reconstitution inflammatory syndrome

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