Manifestation of an Abdominal Immune Reconstitution Inflammatory Syndrome Associated with a Nontuberculous Mycobacterial Infection - A Case Report

作者：Meier B^*; Schmidt A; Kalmar G; Caca K; Wagner D

来源：Zeitschrift für Gastroenterologie, 2013, 51(5): 440-443.

DOI：10.1055/s-0033-1335012

• immune reconstitution inflammatory syndrome
• nontuberculous mycobacterial infection
• mycobacterium avium complex

Immune reconstitution inflammatory syndrome (IRIS) is an inflammatory reaction in HIV-infected patients after initiation of antiretroviral therapy. It results from restored immunity to specific infectious or non-infectious antigens. We describe the case of a 47-year-old female patient who presented with an unspecific painful pressure in the abdomen and weight loss that was diagnosed as intra-abdominal (unmasking) IRIS due to nontuberculous mycobacterial infection (Mycobacterium avium complex). Antiretroviral therapy had been initiated six months earlier when pneumocystis pneumonia led to the diagnosis of HIV infection with a viral load of 123 000 copies/ml and a CD 4 cell count of 6/mu l. Although IRIS is a known complication after initiation of antiretroviral therapy in HIV-infected patients this case with a rare site of manifestation and symptoms that are common in all day gastroenterological clinic highlights a differential diagnosis that requires a high index of suspicion and the need for the careful use of diagnostic tools.

• 出版日期2013-5