Pediatric Renal Cryptococcosis: Novel Manifestations in the Acquired Immunodeficiency Syndrome Era

作者：Ramdial Pratistadevi K^*; Sing Yetish; Deonarain Julian; Bhimma Rajendra; Chotey Nivesh; Sewram Vikash

来源：International Journal of Surgical Pathology, 2011, 19(3): 386-392.

DOI：10.1177/1066896910373923

• cryptococcosis
• C neoformans
• immune reconstitution
• kidney
• AIDS
• HIV

Pediatric cryptococcosis has been documented in various organs, but pediatric renal cryptococcosis (RC) remains undocumented to date. The authors report RC in 2 children with AIDS, 7 and 9 years of age, with proteinuria. Both patients, on antiretroviral therapy (ARV) for 28 (patient 1) and 54 (patient 2) weeks each, had secured viral immunosuppression, but immune restoration was realized by patient 1 only. Cryptococcal immune reconstitution inflammatory syndrome (IRIS) was diagnosed on the renal biopsy from patient 1 based on the clinicopathological profile and the presence of segmental glomerular and an interstitial lymphoplasmacytic and granulomatous reaction to Cryptococcus neoformans, with a predominance of capsule-deficient fungal forms. The renal biopsy from patient 2 demonstrated typical HIV-associated nephropathy with focal intratubular and interstitial C neoformans yeasts. Pediatric AIDS-associated renal disease must be expanded to include RC and cryptococcal IRIS, and the kidney must be included as a potential sentinel site of IRIS.

• 出版日期2011-6