title: Manifestation of an abdominal immune reconstitution inflammatory syndrome associated with a nontuberculous mycobacterial infection - a case report.
abstract: Immune reconstitution inflammatory syndrome (IRIS) is an inflammatory reaction in HIV-infected patients after initiation of antiretroviral therapy. It results from restored immunity to specific infectious or non-infectious antigens. We describe the case of a 47-year-old female patient who presented with an unspecific painful pressure in the abdomen and weight loss that was diagnosed as intra-abdominal (unmasking) IRIS due to nontuberculous mycobacterial infection (Mycobacterium avium complex). Antiretroviral therapy had been initiated six months earlier when pneumocystis pneumonia led to the diagnosis of HIV infection with a viral load of 123 000 copies/ml and a CD 4 cell count of 6/µl. Although IRIS is a known complication after initiation of antiretroviral therapy in HIV-infected patients this case with a rare site of manifestation and symptoms that are common in all day gastroenterological clinic highlights a differential diagnosis that requires a high index of suspicion and the need for the careful use of diagnostic tools.
authors.affiliation: Gastroenterologie, Klinikum Ludwigsburg, 71640 Ludwigsburg. benjamin.meier@kliniken-lb.de
authors.forename: B
authors.initials: B
authors.lastname: Meier
authors.forename: A
authors.initials: A
authors.lastname: Schmidt
authors.forename: G
authors.initials: G
authors.lastname: Kalmar
authors.forename: K
authors.initials: K
authors.lastname: Caca
authors.forename: D
authors.initials: D
authors.lastname: Wagner
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis* / Q000382:microbiology; D003937:Diagnosis, Differential; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000382:microbiology; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis* / Q000382:microbiology*; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000175:diagnosis* / Q000382:microbiology*; D014376:Tuberculosis / Q000175:diagnosis / Q000382:microbiology