Chylous ascites: a late complication of intra-abdominal Mycobacterium avium complex immune reconstitution syndrome in HIV-infected patients.
Chylous ascites related to Mycobacterium avium complex (MAC) in HIV-infected patients is rare, with only six cases reported in the English literature. We report a series of six cases from a single institution. During the past six years, chylous ascites was diagnosed in six (35%) of 17 AIDS patients, all of whom had previously been diagnosed with intra-abdominal MAC immune reconstitution syndrome (MAC-IRS). A review of medical records identified no other cases of chylous ascites among HIV-positive patients over the past 13 years (1994-2007), and the incidence was estimated at one in 2248 HIV-positive admissions. The ascitic fluid had a milky appearance and a median triglyceride level of 4.07 mmol/L (range 3.19-29.6 mmol/L) (360 mg/dL, range 282-2620 mg/dL). After a median follow-up of 20 months, five (83%) of six patients survived. Chylous ascites is a late complication of intra-abdominal MAC-IRS, and is usually associated with a favourable prognosis.
Phillips
P
P
Division of Infectious Diseases, University of British Columbia, Vancouver, BC, Canada. pphillips@cfenet.ubc.ca
Lee
J K
JK
Wang
C
C
Yoshida
E
E
Lima
V D
VD
Montaner
J
J
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000382:microbiology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001202:Ascitic Fluid / Q000737:chemistry; D002915:Chylous Ascites / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications* / Q000382:microbiology; D015994:Incidence; D008297:Male; D015269:Mycobacterium avium Complex; D014280:Triglycerides / Q000032:analysis
D014280:Triglycerides