Acute tubular nephropathy in a patient with acute HIV infection: review of the literature.
We report a 57-year old man with diabetes mellitus and hypertension who presented with acute HIV infection. Routine blood tests showed an elevated blood urea nitrogen and creatinine. Renal biopsy showed acute tubular nephropathy, which has not been reported to occur during acute HIV infection, in the absence of rhabdomyolysis or multiple organ system failure. Antiretroviral therapy was initiated. His renal failure gradually resolved without further intervention. At one year of follow-up his HIV RNA was undetectable, and his renal function was normal. The case illustrates a rare manifestation of acute HIV infection - acute renal failure - in an older man with diabetes and hypertension. In this setting acute kidney injury might mistakenly have been attributed to his chronic comorbidities, and this case supports early HIV-1 testing in the setting of a high index of suspicion.
SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand ; Department of Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV, Pathumwan, Bangkok 10330 Thailand ; US Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA ; US Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD 20817 USA.
Jintanat
J
Ananworanich
Division of Nephropathology, Joint Pathology Center, 606 Stephen Sitter Avenue, Silver Spring, MD 20910 USA.
Anandita A
AA
Datta
SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
James Lk
JL
Fletcher
Department of Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV, Pathumwan, Bangkok 10330 Thailand.
Natavudh
N
Townamchai
SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
Nitiya
N
Chomchey
SEARCH, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
Eugene
E
Kroon
Clinical and Molecular Retrovirology Section/ Laboratory of Immunoregulation, 10 Center Drive, building 10, room 11B-07A, Bethesda, MD 20892 USA.
Irini
I
Sereti
Memory and Aging Center, University of California at San Francisco, Suite 905, 350 Parnassus Avenue, San Francisco, CA 94143 USA.
Victor
V
Valcour
US Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA.
Jerome H
JH
Kim
Acute HIV infection; Acute renal failure; Acute retroviral syndrome; Acute tubular nephropathy; Elderly; HIV