HHV-8 DNA Sequences in the Peripheral Blood and Skin Lesions of an HIV-Negative Patient with Multiple Eruptive Dermatofibromas: Implications for the Detection of HHV-8 as a Diagnostic Marker for Kaposi’s Sarcoma

Abstract Case Description: - A 76 year old lady was diagnosed with Chronic Lymphocytic Leukemia (CLL) with 11 q deletion after she presented with generalized lymphadenopathy and anemia. She was treated with rituximab 375mg/m2 day1 and bendamustine 60mg/m2 on day 1 and day 2 and completed six cycles of treatment. After the sixth cycle she developed multiple itchy, papular lesions with bleeding on both lower extremities. She was evaluated multiple times by vascular surgery and dermatology without a definitive diagnosis. She underwent a biopsy with staining for HHV-8, CD31 and CD34 which was positive confirming the diagnosis of Kaposi sarcoma. ELISA test for HIV was negative. She was started on treatment with Doxorubicin 20 mg/m2every 3 weeks and with 3 cycles there was significant regression of the lesions. Discussion-: We describe a case of CLL which was initially started on treatment with rituximab and bendamustine. She tolerated the treatment well, but a few months later presented with skin lesions which on biopsy was diagnosed as Kaposi sarcoma. It is very uncommon for Kaposi sarcoma to develop in a HIV negative patient. This patient was immunocompromised with recent chemotherapy. Rituximab specifically depletes B cells and leads to impaired T cell mediated immunity. This case illustrates the importance of a high index of suspicion in patients treated with rituximab as it is used for a number of hematologic malignancies like leukemia, lymphoma as well as non-malignant conditions like autoimmune disorders. While infusion reactions and reactivation of hepatitis B are side effects physicians are aware of and cautious of while using rituximab, Kaposi’s Sarcoma remains a less known side effect. Awareness of this possibility is important in physicians prescribing rituximab. Footnotes * Asterisk with author names denotes non-ASH members. Disclosures No relevant conflicts of interest to declare.

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Simultaneous Kaposi's sarcoma and Castleman's disease in a HIV-negative patient. Response to rituximab and doxorubicin

Medicina Clínica ◽

10.1016/j.medcli.2019.09.013 ◽

2020 ◽

Vol 155 (12) ◽

pp. 565-566

Author(s):

Mónica García-Arpa ◽

Carmen Calle-Primo ◽

Francisco Martín-Dávila

Keyword(s):

Kaposi's Sarcoma ◽

Castleman’S Disease ◽

Kaposi’S Sarcoma ◽

Castleman's Disease ◽

Patient Response ◽

Negative Patient ◽

Hiv Negative

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Kaposi’s sarcoma in an HIV-negative patient

Dermatology Online Journal ◽

10.5070/d32212033378 ◽

2016 ◽

Vol 22 (12) ◽

Author(s):

Shields Callahan ◽

Randie H Kim ◽

Nooshin Brinster ◽

Jo-Ann Latkowski

Keyword(s):

Kaposi's Sarcoma ◽

Kaposi’S Sarcoma ◽

Negative Patient ◽

Hiv Negative

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Kaposi's sarcoma (KS)-associated herpesvirus-like DNA sequences in peripheral blood mononuclear cells: association with KS and persistence in patients receiving anti-herpesvirus drugs

Blood ◽

10.1182/blood.v88.1.297.297 ◽

1996 ◽

Vol 88 (1) ◽

pp. 297-301 ◽

Cited By ~ 43

Author(s):

RW Humphrey ◽

TR O'Brien ◽

FM Newcomb ◽

H Nishihara ◽

KM Wyvill ◽

...

Keyword(s):

Peripheral Blood Mononuclear Cells ◽

Dna Sequences ◽

Peripheral Blood ◽

Kaposi's Sarcoma ◽

Mononuclear Cells ◽

Kaposi’S Sarcoma ◽

Peripheral Blood Mononuclear ◽

Therapeutic Implications ◽

Blood Mononuclear Cells ◽

Cd4 Lymphocyte

Abstract Herpesvirus-like DNA sequences (KSHV/HHV-8) have recently been described in AIDS-associated Kaposi's sarcoma (KS) lesions. Many questions remain regarding the role of this virus in KS and the therapeutic implications of this finding. In the current study, KSHV/HHV-8 DNA was detected in peripheral blood mononuclear cells (PBMCs) from human immunodeficiency virus (HIV)-infected patients with KS (34/98) more often than in HIV-infected individuals without KS (12/64, P = .03). The detection of KSHV/HHV-8 DNA did not correlate with the CD4 lymphocyte count. Five patients demonstrated KSHV/HHV-8 DNA in their PBMCs during administration of intravenous foscarnet and/or ganciclovir. The continued detection of KSHV/HHV-8 DNA in the PBMCs of patients receiving these anti-herpesvirus drugs has potential implications regarding the virus-cell relationship of KSHV/HHV-8, as well as for the value of these drugs in treating or preventing KS, but additional studies are needed.

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Simultaneous Association of Pulmonary Tuberculosis and Kaposi’s Sarcoma in an Immunocompetent Subject: A Case Report and Literature Review

Case Reports in Pulmonology ◽

10.1155/2019/5453031 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Sofia Baina ◽

Jihane Achrane ◽

Jouda Benamor ◽

Jamal Eddine Bourkadi

Keyword(s):

Case Report ◽

Literature Review ◽

Pulmonary Tuberculosis ◽

Kaposi's Sarcoma ◽

Kaposi’S Sarcoma ◽

Hiv Positive ◽

Negative Patient ◽

Different Types ◽

Hiv Negative

Kaposi’s Sarcoma (KS) occurs as a pathological entity that may be classified into four different types: classic, endemic, epidemic, and iatrogenic. It can arise among HIV-positive subjects or within immunosuppression, yet exceptionally of tuberculous origin. We describe a new case report of an HIV-negative patient, manifesting Kaposi’s disease in the course of tuberculosis, with the aim to assess this uncommon disorder and to outline this rare atypical association.

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