title: Intestinal lymphangiectasia: an undescribed cause of malabsorption and incomplete immunological recovery in HIV-infected patients.
abstract: BACKGROUND
  Although paradoxical virological and immunological response after HAART has been well studied, intestinal lymphangiectasia (IL) in HIV-1 infected patients has not previously described.
  
  
  METHODS
  To describe HIV patients who developed IL.
  
  
  METHODS
  Clinical Case series.
  
  
  METHODS
  4 patients with HIV and IL diagnosis based on clinical, endoscopic and pathological findings.
  
  
  RESULTS
  All four cases had prior mycobacterial infections with abdominal lymph node involvement and a very low CD4 cell count nadir. They developed intestinal lymphangiectasia despite appropriate virological suppression with HAART and repeatedly negative mycobacterial cultures. Two patients were clinically symptomatic with oedemas, ascites, diarrhoea, asthenia, weight loss; but the other two were diagnosed with malabsorption as a result of laboratory findings, with hypoproteinemia and hypoalbuminemia. Three of them were diagnosed by video capsule endoscopy.
  
  
  CONCLUSIONS
  IL should be considered in HIV-1 infected patients who present with clinical or biochemical malabsorption parameters when there is no immunological recovery while on HAART.
authors.affiliation: Servicio de Medicina Interna, Hospital Son Llàtzer, Palma de Mallorca, Spain.
authors.forename: Maria D
authors.initials: MD
authors.lastname: Marco-Lattur
authors.forename: Antoni
authors.initials: A
authors.lastname: Payeras
authors.forename: Antoni A
authors.initials: AA
authors.lastname: Campins
authors.forename: Jaume
authors.initials: J
authors.lastname: Pons
authors.forename: Carmen
authors.initials: C
authors.lastname: Cifuentes
authors.forename: Melcior
authors.initials: M
authors.lastname: Riera
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D053704:Capsule Endoscopy; D017809:Fatal Outcome; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D015497:HIV-1; D006801:Humans; D007019:Hypoproteinemia / Q000209:etiology; D008201:Lymphangiectasis, Intestinal / Q000150:complications* / Q000175:diagnosis; D008286:Malabsorption Syndromes / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications; D014391:Tuberculosis, Miliary / Q000150:complications
chemical_list: D019380:Anti-HIV Agents