Sarcoidosis and HIV infection: a case report and a review of the literature

Abstract

Sarcoidosis occurring in patients with AIDS is rare. This infrequent association has been attributed to the impairment of the immune system that may interfere with the granuloma formation in HIV infected patients. However, the introduction of highly active antiretroviral therapy (HAART) has brought about a substantial and sustained increase in CD4+ T lymphocyte cells, and has consequently led to the development of the so called “immune restoration disease”. The case of an HIV infected man who developed sarcoidosis after the initiation of HAART is described. Skin nodule images and histological specimens are reported. The association between sarcoidosis and HIV infection is also reviewed.

Coexistent sarcoidosis and HIV infection: an immunological paradox?

“…28 This could explain patients with active pulmonary sarcoidosis and peripheral blood CD4 counts less than 200/mm 3 . Perhaps, the low CD4/CD8 ratio of the patient described by Blanche et al, and the normal CD4/ CD8 ratio in the BAL fluid of the patient described by Trevenzoli et al 22 and in our patient, is related to a lower count number of peripheral blood CD4 lymphocytes able to be recruited.…”

Immune reconstitution sarcoidosis presenting with hypercalcaemia and renal failure in HIV infection

“…1,4,5 More recently, sarcoidosis in patients receiving HAART has been described and this is thought to be a manifestation of Immune Reconstitution Inflammatory Syndrome (IRIS). [5][6][7][8][9] Our patient's symptoms began 12 months after starting HAART, to which he had a good immunological response. Although it is possible that the diagnosis was coincidental to HIV infection, it is unusual for sarcoidosis to present de novo at this age, and so it is likely that sarcoidosis represents a manifestation of IRIS.…”

Immune reconstitution inflammatory syndrome associated with pulmonary sarcoidosis in an HIV-infected patient: an immunohistochemical study

“…1,[6][7][8][9][10][11][12][13][14][15][16][17][18][19] All cases ruled out infectious agents and demonstrated sarcoidosis by anatomopathological findings. Two of these patients presented the symptoms after therapy with IL-2.…”