title: Occult lymphadenopathic Kaposi's sarcoma associated with severe pulmonary hypertension: A clinical hint about the potential role of HHV-8 in HIV-related pulmonary hypertension?
abstract: Severe pulmonary hypertension (PH) mimicking idiopathic PH is an increasingly recognized complication of human immunodeficiency virus (HIV) infection. PH shares several histopathologic features with Kaposi's sarcoma (KS), the most common malignancy in AIDS patients, and molecular evidence of the vasculotropic Kaposi's sarcoma-associated herpesvirus or human herpesvirus 8 (HHV-8) has been found in the lung tissue of patients with the disease. Although the prevalence of HHV-8 infection is increased among HIV-infected patients, no clinical association between KS and PH has ever been reported. Herein, we described a 30-year-old HIV-infected female co-infected with HHV-8 who developed severe PH coincident with occult KS. The clinical presentation of KS was unusual and remained masqueraded for years as an indolent cervical lymphadenopathy, without the typical cutaneous lesions. This is the first ever-reported case of PH associated with KS. Although the co-occurrence of both diseases in this patient could have been just a coincidence, the observation may also indicate that a relationship between HHV-8 infection and HIV-associated PH exists. Coinfection with HHV-8 and occult lymphadenopatic KS should be considered in HIV-infected patients developing PH.
authors.affiliation: Infectious Diseases Unit, Internal Medicine Department, Hospital General Universitario de Elche, Alicante, Spain. gutierrez_fel@gva.es
authors.forename: Félix
authors.initials: F
authors.lastname: Gutiérrez
authors.forename: Mar
authors.initials: M
authors.lastname: Masiá
authors.forename: Sergio
authors.initials: S
authors.lastname: Padilla
authors.forename: José M
authors.initials: JM
authors.lastname: Ramos
authors.forename: Enrique
authors.initials: E
authors.lastname: Bernal
authors.forename: Pilar
authors.initials: P
authors.lastname: Morales
authors.forename: Francisco
authors.initials: F
authors.lastname: Pozo
authors.forename: Encarnación
authors.initials: E
authors.lastname: Andrada
authors.forename: Alberto
authors.initials: A
authors.lastname: Martin-Hidalgo
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D019288:Herpesvirus 8, Human / Q000472:pathogenicity*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology*; D012514:Sarcoma, Kaposi / Q000150:complications*