Pediatric Kaposi's sarcoma associated with immune reconstitution inflammatory syndrome

Abstract

Immune reconstitution inflammatory syndrome (IRIS) represents paradoxical immune-mediated inflammation in response to an infecting pathogen, occurring after initiation of antiretroviral therapy (ART), concomitantly with immune system recovery. It has also been described in Kaposi's sarcoma (KS). We report a case of a 9-year-old Guinean girl, who developed Kaposi's sarcoma, following introduction of ART. KS associated with immune reconstitution inflammatory syndrome is rare, especially in children, but with the increased use of ART is becoming more prevalent. Pediatric Dermatology BRIEF REPORTA skin biopsy with immunohistochemistry for HHV8 confirmed the diagnosis of KS (Figure 2). In this context, a diagnosis of KS secondary to IRIS was made. The patient continued with ART, and after 1 year, she has a normal CD4 cell count, undetectable HIV load and the skin lesions resolved leaving only residual hyperpigmented patches.

Immune Reconstitution Inflammatory Syndrome Associated Kaposi Sarcoma

“…More atypical presentations of KS-IRIS have been reported, such as oral localization [ 75 ], chylous ascites and chylothorax [ 67 ]. Although rare, KS-IRIS can also be observed in children, as recently reported in a 9-year-old Guinean girl [ 76 ].…”

Skin and mucosal manifestations of immune reconstitution inflammatory syndrome in people living with HIV: a review

“…No specific treatment was needed for the lesions to resolve. 38 It is also worth mentioning that the recently published report highlights the impact of glucocorticoid use on mortality in Kaposi's sarcoma-IRIS. A Mexican team with a series of 145 patients with HIV-associated Kaposi's sarcoma receiving ART tried to study this association.…”

“…A 9‐year‐old Guinean girl presented nodular, brown lesions located on both thighs and her right leg after starting ART. No specific treatment was needed for the lesions to resolve 38 . It is also worth mentioning that the recently published report highlights the impact of glucocorticoid use on mortality in Kaposi's sarcoma‐IRIS.…”