scholarly journals Case Report: Pulmonary Kaposi Sarcoma in a non-HIV patient

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 1013 ◽  
Author(s):  
Arber Kodra ◽  
Maciej Walczyszyn ◽  
Craig Grossman ◽  
Daniel Zapata ◽  
Tarak Rambhatla ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Skin Diseases ◽  
Case Reports ◽  
Kaposi Sarcoma ◽  
B Cell Lymphoma ◽  
Pulmonary Involvement ◽  
Skin Lesions ◽  
Human Herpes Virus 8 ◽  
Bronchoscopic Biopsy ◽  
Immunodeficiency Syndrome

Kaposi Sarcoma (KS) is an angioproliferative tumor associated with human herpes virus 8 (HHV-8).  Often known as one of the acquired immunodeficiency syndrome (AIDS)-defining skin diseases, pulmonary involvement in KS has only been discussed in a handful of case reports, rarely in a non-HIV patient. Herein we report the case of a 77 year-old- male who presented with a 6-week history of progressive dyspnea on exertion accompanied by productive cough of yellow sputum and intermittent hemoptysis. His past medical history was significant for Non-Hodgkin’s Follicular B-Cell Lymphoma (NHL). Patient also had biopsy-confirmed cutaneous KS. His physical exam was notable for a 2cm firm, non-tender, mobile right submandibular lymph node.  Lungs were clear to auscultation. He had multiple violet non-tender skin lesions localized to the lower extremities. CT scan of the chest showed numerous nodular opacities and small pleural effusions in both lungs. A thoracenthesis was performed, showing sero-sanguineous exudative effusions. Histopathology failed to demonstrate malignant cells or lymphoma. A subsequent bronchoscopy revealed diffusely hyperemic, swollen mucosa of the lower airways with mucopurulent secretions. Bronchoalveolar lavage PCR for HHV-8 showed 5800 DNA copies/mL.  It was believed that his pulmonary symptoms were likely due to disseminated KS.  This case illustrates the potential for significant lung injury from KS. It also demonstrates the use of PCR for HHV-8 to diagnose KS in a bronchoalveolar lavage sample in a case when bronchoscopic biopsy was not safe. Furthermore, this case is unique in that the patient did not match the typical KS subgroups as HIV infection and other immune disorders were ruled out. Recognition of this syndrome is critical to the institution of appropriate therapy. As such, this case should be of interest to a broad readership across internal medicine including the specialties of Pulmonology and Critical Care.

scholarly journals Impact of valganciclovir therapy on severe IRIS-Kaposi Sarcoma mortality: an open-label, parallel, randomized controlled trial.

2021 ◽  
Author(s):  
Patricia Volkow ◽  
Leslie Chavez-Galan ◽  
Lucero Ramon-Luing ◽  
Judith Cruz-Velazquez ◽  
Patricia Cornejo-Juarez ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Kaposi Sarcoma ◽  
Pulmonary Involvement ◽  
Skin Lesions ◽  
Attributable Mortality ◽  
Control Group ◽  
Open Label ◽  
Parallel Group ◽  
Pulmonary Lymph Node ◽  
The Difference

High HHV-8 viral load (VL) in Kaposi Sarcoma (KS) has been associated with severe Immune reconstitution inflammatory syndrome (S-IRIS-KS), which can occur after initiating cART, and is linked with high mortality particularly in patients with pulmonary involvement. We investigate if valganciclovir initiated before cART decreases HHV-8 VL and assess if it reduces the incidence of S-IRIS-KS and its attributable mortality. Methods: Open-label parallel-group randomized clinical trial in AIDS cART naive patients with disseminated KS (DKS) as defined by at least two of the following: pulmonary, lymph-node or gastrointestinal involvement, lymphedema, or equal or more 30 skin lesions. In the experimental group (EG), patients were randomized to valganciclovir 900 mg BID four weeks before cART and continued until week-48; in the control group (CG), cART was initiated on week-0. Non-severe-IRIS-KS was defined as: increase in the number of lesions plus equal or more than one log10 HIV-VL decrease or equal or more than 50 cells/mm3 increase or equal or more than 2-fold rise in baseline CD4+ cells. S-IRIS-KS was defined as abrupt clinical worsening of KS lesions and/or fever after ruling out another infection following cART initiation, and at least three of the following: thrombocytopenia, anemia, hyponatremia, or hypoalbuminemia. Results: 40 patients were randomized and 37 completed the study. In the ITT analysis, the overall mortality did not differ between groups. In the per-protocol analyses, the difference showed a trend for higher S-IRIS-KS mortality in the CG 3/19 (15.7%), compared to EG 0/18 (p=0.07). The incidence of S-IRIS KS was significantly lower in the EG; two patients, one each had S-IRIS-KS episode (0.038 per 100 patient-days) compared to CG group, four patients developed 12 S-IRIS-KS episodes (0.21 per 100 patient-days); incidence rate of 0.09 (95% CI 0.02-0.5 p=0.006). Mortality in patients with pulmonary KS was significantly lower in EG, 3/4 in CG vs 0/5 in EG. S-IRIS-KS was associated with higher HHV-8-VL; IL6 and CRP; valganciclovir was protective. Of survivors at week 48, 82% achieved more than 80% remission. No difference was found between groups in the number of non-S-IRIS-KS events. Conclusions: Valganciclovir significantly reduced the episodes of S-IRIS-KS although attributable KS mortality was lower in the EG the difference was not significant (p=0.07). Mortality was significantly lower in EG patients with pulmonary KS.

scholarly journals Skin Lesions and Lower Extremity Edema in a newly diagnosed HIV patient

1970 ◽  
Vol 1 (1) ◽  
pp. 12-15
Author(s):  
Andrew B Trotter ◽  
Debra D Poutsiaka
Keyword(s):  
Differential Diagnosis ◽  
Lower Extremity ◽  
Highly Active Antiretroviral Therapy ◽  
Kaposi Sarcoma ◽  
Pulmonary Involvement ◽  
The United States ◽  
Skin Lesions ◽  
Newly Diagnosed ◽  
Mortality And Morbidity ◽  
Highly Active

The differential diagnosis of skin lesions in human immunodeficiency virus patients is diverse and includes both infectious and non infectious causes. In this case presentation, a 37 year old male newly diagnosed with HIV presented to a hospital in the United States with skin lesions and worsening lower extremity swelling. After presentation, he developed respiratory distress and was found to have disseminated Kaposi sarcoma with cutaneous and pulmonary involvement. Kaposi sarcoma has decreased in incidence in the era of highly active antiretroviral therapy. However, it remains an important acquired immunodeficiency syndrome defining illness which may be the presenting complaint in a patient with occult HIV infection. Kaposi sarcoma has substantial mortality and morbidity and should be included in the differential diagnosis of skin lesions in a HIV positive patient. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5833 Journal of Advances in Internal Medicine. 2012; 1(1): 12-15

ORAL KAPOSI SARCOMA IN PATIENTS WITH ACQUIRED IMMUNODEFICIENCY SYNDROME: CASE REPORTS

2020 ◽  
Vol 129 (1) ◽  
pp. e99
Author(s):  
GLEICY GABRIELA V.S.C. FALCÃO ◽  
CAROLINA GUIMARÃES BONFIM ALVES ◽  
PEDRO ANTÔNIO DE JESUS MOUREIRA ◽  
VINICIUS DA COSTA VIEIRA ◽  
LILIANE ELZE PALCÃO LINS KUSTERER ◽  
...  
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Case Reports ◽  
Kaposi Sarcoma ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Pulmonary Involvement of Kaposi Sarcoma in an AIDS Patient: Radiologic and Pathologic Findings

2002 ◽  
Vol 46 (1) ◽  
pp. 37 ◽  
Author(s):  
Seung Ho Kim ◽  
Jin Mo Goo ◽  
Jun Woo Lee ◽  
Myung Jin Chung ◽  
Yu Jin Lee ◽  
...  
Keyword(s):  
Kaposi Sarcoma ◽  
Pulmonary Involvement ◽  
Pathologic Findings

Research Progress of Glycyrrhizic Acid on Antiviral Activity

2019 ◽  
Vol 19 (10) ◽  
pp. 826-832 ◽  
Author(s):  
Zhi-Gang Sun ◽  
Ting-Ting Zhao ◽  
Na Lu ◽  
Yong-An Yang ◽  
Hai-Liang Zhu
Keyword(s):  
Hepatitis B ◽  
Glycyrrhizic Acid ◽  
Skin Diseases ◽  
Hepatitis B Surface Antigen ◽  
Research Progress ◽  
Extracellular Secretion ◽  
Antiviral Effects ◽  
B Virus ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Glycyrrhizic acid (GA), a triterpene isolated from the roots and rhizomes of licorice, named Glycyrrhiza glabra, is the principal bioactive ingredient of anti-viral, anti-inflammatory and hepatoprotective effects. GA has been used in the clinical treatment of hepatitis, bronchitis, gastric ulcer, AIDS (acquired immunodeficiency syndrome), certain cancers and skin diseases. It has a direct effect on anti-HBV (hepatitis B virus) via affecting the HBsAg (hepatitis B surface antigen) to extracellular secretion, improving liver dysfunction in patients with chronic hepatitis B, and ultimately improving the immune status of HBV. GA can significantly inhibit the proliferation of HIV, showing an immune activation. The clinical application of GA on the prevention and treatments of various diseases may derive from its numerous pharmacological properties. This review provides the summary of the antiviral effects of GA on research progress and mechanism in recent years.

scholarly journals Epidemiology of Non-Hodgkin’s Lymphoma

2021 ◽  
Vol 9 (1) ◽  
pp. 5
Author(s):  
Krishna C. Thandra ◽  
Adam Barsouk ◽  
Kalyan Saginala ◽  
Sandeep Anand Padala ◽  
Alexander Barsouk ◽  
...  
Keyword(s):  
T Cell ◽  
Radiation Treatment ◽  
Cell Lymphoma ◽  
Breast Implants ◽  
Occupational Exposures ◽  
B Cell Lymphoma ◽  
Large Cell ◽  
T Cell Lymphoma ◽  
Human Herpes Virus 8 ◽  
Human T Cell

Non-Hodgins’s lymphoma (NHL) is the most common hematological malignancy worldwide, accounting for nearly 3% of cancer diagnoses and deaths. NHL is the seventh most prevalent cancer and has the sixth highest mortality among cancers in the US. NHL accounts for 4% of US cancer diagnoses, and incidence has increased 168% since 1975 (while survival has improved 158%). NHL is more common among men, those >65 years old, and those with autoimmune disease or a family history of hematological malignancies. NHL is a heterogenous disease, with each subtype associated with different risk factors. Marginal zone lymphoma (MZL) is strongly associated with Sjogren’s syndrome (SS) and Hashimoto’s thyroiditis, while peripheral T-cell lymphoma (PTCL) is most associated with celiac disease. Occupational exposures among farm workers or painters increases the risk of most of the common subtypes. Prior radiation treatment, obesity, and smoking are most highly associated with diffuse large B-cell lymphoma (DLBCL), while breast implants have been rarely associated with anaplastic large cell lymphoma (ALCL). Infection with Epstein–Barr Virus (EBV) is strongly associated with endemic Burkitts lymphoma. HIV and human herpes virus 8 (HHV-8), is predisposed to several subtypes of DLBCL, and human T-cell lymphoma virus (HTLV-1) is a causative agent of T-cell lymphomas. Obesity and vitamin D deficiency worsen NHL survival. Atopic diseases and alcohol consumption seem to be protective against NHL.

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