Abstract
The diagnosis of sarcoidosis in a patient living with HIV infection is an uncommon event and a challenge for clinicians. Clinical manifestations are variable and fluctuating depending to adherence to ARV therapy and to the level of CD4 count. We analyze here one chronic case in which sarcoidosis appeared clinically two years after pulmonary tuberculosis. The course of the disease was influenced and prolonged by frequent interruptions of antiretroviral therapy. Moreover the diagnosis and the decision to treat have been delayed by the need of exclusion of other pathologies, principally tuberculosis reactivation/reinfection, other mycobacterial diseases, hematologic malignancies. We propose a simplified flowchart for diagnosis and follow up of sarcoidosis, which may also be applied to patients with HIV infection. Diagnosis of latent tuberculosis infection (LTBI) may be difficult in these patients, because the immunological paradox of sarcoidosis. For this reason, following exclusion of active tuberculosis, we advise to submit all sarcoidosis patients to IPT (isoniazid preventive therapy), when immunosuppressive therapy is started.
| Original language | English |
|---|---|
| Pages (from-to) | 150-154 |
| Number of pages | 5 |
| Journal | Respiratory Medicine Case Reports |
| Volume | 19 |
| DOIs | |
| Publication status | Published - 2016 |
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Keywords
- Diagnostic flowchart
- HIV infection
- Sarcoidosis
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Pulmonary tuberculosis followed by sarcoidosis in an HIV-infected patient : A case report and a simplified diagnostic flowchart for diagnosis and treatment of sarcoidosis. / Mencarini, P.; Bellagamba, R.; Oliva, A.; Ghirga, P.; Giancola, M. L.; Corpolongo, A.; Ascoli Bartoli, T.; De Nardo, P.; Baiocchini, A.; Del Nonno, F.; Narciso, P.; Nicastri, E.
In: Respiratory Medicine Case Reports, Vol. 19, 2016, p. 150-154.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pulmonary tuberculosis followed by sarcoidosis in an HIV-infected patient
T2 - A case report and a simplified diagnostic flowchart for diagnosis and treatment of sarcoidosis
AU - Mencarini, P.
AU - Bellagamba, R.
AU - Oliva, A.
AU - Ghirga, P.
AU - Giancola, M. L.
AU - Corpolongo, A.
AU - Ascoli Bartoli, T.
AU - De Nardo, P.
AU - Baiocchini, A.
AU - Del Nonno, F.
AU - Narciso, P.
AU - Nicastri, E.
PY - 2016
Y1 - 2016
N2 - The diagnosis of sarcoidosis in a patient living with HIV infection is an uncommon event and a challenge for clinicians. Clinical manifestations are variable and fluctuating depending to adherence to ARV therapy and to the level of CD4 count. We analyze here one chronic case in which sarcoidosis appeared clinically two years after pulmonary tuberculosis. The course of the disease was influenced and prolonged by frequent interruptions of antiretroviral therapy. Moreover the diagnosis and the decision to treat have been delayed by the need of exclusion of other pathologies, principally tuberculosis reactivation/reinfection, other mycobacterial diseases, hematologic malignancies. We propose a simplified flowchart for diagnosis and follow up of sarcoidosis, which may also be applied to patients with HIV infection. Diagnosis of latent tuberculosis infection (LTBI) may be difficult in these patients, because the immunological paradox of sarcoidosis. For this reason, following exclusion of active tuberculosis, we advise to submit all sarcoidosis patients to IPT (isoniazid preventive therapy), when immunosuppressive therapy is started.
AB - The diagnosis of sarcoidosis in a patient living with HIV infection is an uncommon event and a challenge for clinicians. Clinical manifestations are variable and fluctuating depending to adherence to ARV therapy and to the level of CD4 count. We analyze here one chronic case in which sarcoidosis appeared clinically two years after pulmonary tuberculosis. The course of the disease was influenced and prolonged by frequent interruptions of antiretroviral therapy. Moreover the diagnosis and the decision to treat have been delayed by the need of exclusion of other pathologies, principally tuberculosis reactivation/reinfection, other mycobacterial diseases, hematologic malignancies. We propose a simplified flowchart for diagnosis and follow up of sarcoidosis, which may also be applied to patients with HIV infection. Diagnosis of latent tuberculosis infection (LTBI) may be difficult in these patients, because the immunological paradox of sarcoidosis. For this reason, following exclusion of active tuberculosis, we advise to submit all sarcoidosis patients to IPT (isoniazid preventive therapy), when immunosuppressive therapy is started.
KW - Diagnostic flowchart
KW - HIV infection
KW - Sarcoidosis
UR - http://www.scopus.com/inward/record.url?scp=84991508519&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991508519&partnerID=8YFLogxK
U2 - 10.1016/j.rmcr.2016.09.006
DO - 10.1016/j.rmcr.2016.09.006
M3 - Article
AN - SCOPUS:84991508519
VL - 19
SP - 150
EP - 154
JO - Respiratory Medicine Case Reports
JF - Respiratory Medicine Case Reports
SN - 2213-0071
ER -