Volume 4, Number 16; July 27, 2005
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Volume 4, Number 16; July 27, 2005 |
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69-year-old African-American female with bleeding gums
Recommended reading:
Fatal Kaposi's sarcoma-associated immune reconstitution following HAART initiation.
Histological features of kaposi sarcoma in a patient receiving highly active antiviral therapy.
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Patient:
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Session Handout:
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Clinical Question: 1) Is immune reconstitution syndrome a recognized phenomenon in malignancy?
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Readings:
Link Directly to Fulltext article in Ovid <1> Unique Identifier [PMID]: 15705280 Authors: Crane HM. Deubner H. Huang JC. Swanson PE. Harrington RD. Institution: Department of Medicine, Center for AIDS and STD, Seattle, WA, USA. hcrane@u.washington.edu Title: Fatal Kaposi's sarcoma-associated immune reconstitution following HAART initiation.
Source: International Journal of STD & AIDS. 16(1):80-3, 2005 Jan. Abstract: This unique report describes a fatal case of immune reconstitution syndrome associated with Kaposi's sarcoma (KS). This case also illustrates the possibility of cryptic visceral KS with minimal cutaneous disease, as well as the potential for differential responses of cutaneous and visceral KS to treatment. Publication Type: Case Reports. Journal Article.
Link Directly to Fulltext article in Ovid <3> Unique Identifier [PMID]: 15024195 Authors: Eng W. Cockerell CJ. Institution: LabCorp, Tampa, FL, USA. Title: Histological features of kaposi sarcoma in a patient receiving highly active antiviral therapy.
Source: American Journal of Dermatopathology. 26(2):127-32, 2004 Apr. Abstract: The introduction of highly active anti-retroviral therapy (HAART) has changed the clinical presentation of skin diseases in patients with the Acquired Immune Deficiency Syndrome (AIDS). This occurs as a consequence of a newly recognized effect of this therapy known as the "Immune Reconstitution Syndrome," which develops with improvement of immunity. One manifestation of this syndrome is alteration of the natural history of Kaposi sarcoma (KS). While there are multiple reports of KS regression during HAART, there is little documentation of the histologic changes that occur. We present the case of a 55-year-old homosexual male with KS for over 4 years who underwent 6 biopsies over a 3-year period before, during, and after HAART. Kaposi sarcoma lesions prior to HAART were multinodular with ill-defined borders clinically and demonstrated typical features of nodular stage KS histologically. After initiation of HAART in this patient, lesions became uninodular, well circumscribed, and histologically were noted to be less cellular and surrounded by a dense fibrotic stroma. Although the mechanisms for these histologic changes are not clear, it may be due to activity of HAART against human herpesvirus type 8 (HHV-8), the causative agent of KS, to reconstitution of immunity due to diminution in HIV viral load, or both. Publication Type: Case Reports. Journal Article.
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Resident Report / Department of Medicine & Grady Branch Library Emory University School of Medicine 2005 Edition Participating Faculty: Carlos Del Rio MD / Joyce Doyle MD / Lorenzo Difrancesco MD / Erich Folch MD / Alicia Hidron MD
Contact:
Karl Woodworth
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