title: [A paradox: sarcoidosis in an HIV-positive patient].
abstract: BACKGROUND
  In view of the diminished number of CD4+ lymphocytes, the co-existence of an HIV infection and sarcoidosis seems paradoxical. Immune reconstitution inflammatory syndrome (IRIS) may be observed in response to anti-retroviral therapy (ART). According to the conventional definition, this is caused by an overwhelming immune response to an already present or to a new agent.
  
  
  METHODS
  We describe the case of a 47-year-old HIV-positive patient, who presented with an exacerbation of his sarcoidosis nine months after initiation of ART. Based on the time course and the dynamics of the CD4+ lymphocyte count, this presentation of disease can be placed in the context of IRIS.
  
  
  CONCLUSIONS
  The presentation or exacerbation of sarcoidosis after initiation of antiretroviral therapy in HIV-positive patients with a low CD4+ count at start of therapy can be placed in the context of IRIS.
authors.affiliation: Onze Lieve Vrouwe Gasthuis, Amsterdam.
authors.forename: Coen
authors.initials: C
authors.lastname: van Kan
authors.forename: Jan
authors.initials: J
authors.lastname: Peringa
authors.forename: Armin W
authors.initials: AW
authors.lastname: Walter
authors.forename: P H J Jos
authors.initials: PH
authors.lastname: Frissen
authors.forename: Paul
authors.initials: P
authors.lastname: Bresser
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000453:epidemiology* / Q000276:immunology