Surviving a crisis of HIV-associated immune reconstitution syndrome.
The management of life-threatening complications in HIV-associated immune reconstitution syndrome is becoming a challenging scenario in emergency practice, especially in the era of highly active antiretroviral therapy paralleled by increased worldwide incidence of HIV infection. Here, we described a 37-year-old woman with acute hypoxic respiratory failure, acute renal failure, and hypercalcemic crisis as the presenting features of HIV-associated immune reconstitution syndrome. In this patient, the restored granulomatous host response toward isolated pulmonary Mycobacterium avium complex infection led to a near-fatal catastrophe. This report reinforces the importance of introducing a rapid, systematic approach of hypercalcemia at the emergency department and the need for clinicians to maintain awareness of this distinct manifestation.
Division of Nephrology, Department of Medicine, Taoyuan General Hospital, Taoyuan, Taiwan.
Yu-Tzu
YT
Tsao
Shih-Wei
SW
Lee
Jin-Chyr
JC
Hsu
Feng-Ming
FM
Ho
Wei-Jie
WJ
Wang
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000628:therapy; D054019:Immune Reconstitution Inflammatory Syndrome / Q000209:etiology*; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications
D019380:Anti-HIV Agents