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.

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. - ISSN 2213-0071. - STAMPA. - 19:(2016), pp. 150-154. [10.1016/j.rmcr.2016.09.006]

Pulmonary tuberculosis followed by sarcoidosis in an HIV-infected patient: a case report and a simplified diagnostic flowchart for diagnosis and treatment of sarcoidosis

Ascoli Bartoli, T.;
2016

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.
2016
diagnostic flowchart; HIV infection; sarcoidosis; pulmonary and respiratory medicine
01 Pubblicazione su rivista::01i Case report
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. - ISSN 2213-0071. - STAMPA. - 19:(2016), pp. 150-154. [10.1016/j.rmcr.2016.09.006]
File allegati a questo prodotto
File Dimensione Formato  
Mencarini_Pulmonary-tubercolosis_2016.pdf

accesso aperto

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 366.03 kB
Formato Adobe PDF
366.03 kB Adobe PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1122177
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 4
  • ???jsp.display-item.citation.isi??? 2
social impact