title: Occlusive vasculopathy in human immunodeficiency virus (HIV)-associated vasculitis: unusual clinical and imaging course.
abstract: Human immunodeficiency virus (HIV)-associated vasculitis is a rare secondary systemic vasculitis involving small and medium arteries. We report a 42-year-old man with uncontrolled HIV infection presenting with long-lasting abdominal pain. An abdominal CT angiography revealed multiple microaneurysms and stenoses in intrarenal arteries, with involvement of mesenteric and hepatic arteries. HIV-associated vasculitis was diagnosed and glucocorticoids and raltegravir-based antiretroviral therapy were administered with good initial clinical and virological response. Several episodes of acute intestinal ischaemia were later developed requiring bowel resections of which histological examination showed vascular occlusive fibrotic changes without active vasculitic lesions. Vasculitis persisted in remission and intrarenal microaneurysms disappeared.
authors.affiliation: Department of Radiology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
authors.forename: Enric
authors.initials: E
authors.lastname: Ripoll
authors.affiliation: Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Prieto-González
authors.affiliation: Department of Anatomic Pathology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Balagué
authors.affiliation: Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Marco-Hernández
authors.affiliation: Infectious Diseases Service; Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Miró
authors.affiliation: Department of Radiology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Darnell
authors.affiliation: Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Cid
authors.affiliation: Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain. jhernan@clinic.ub.es.
authors.forename: José
authors.initials: J
authors.lastname: Hernández-Rodríguez
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D001706:Biopsy; D000072226:Computed Tomography Angiography; D005938:Glucocorticoids / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D019428:HIV Integrase Inhibitors / Q000627:therapeutic use; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging; D065666:Mesenteric Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D000068898:Raltegravir Potassium / Q000627:therapeutic use; D012074:Remission Induction; D012077:Renal Artery / Q000000981:diagnostic imaging; D056647:Systemic Vasculitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D019428:HIV Integrase Inhibitors; D000068898:Raltegravir Potassium