HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Godoy, M. C. B. Articles by Müller, N. L. Search for Related Content PubMed PubMed Citation Articles by Godoy, M. C. B. Articles by Müller, N. L. Social Bookmarking                      What's this?

Imaging Features of Pulmonary Kaposi Sarcoma–Associated Immune Reconstitution Syndrome

¹ Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
² Department of Radiology, New York University School of Medicine, 650 First Ave., 600-A, New York, NY 10016.
³ Division of Infectious Diseases, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
⁴ Division of Infectious Diseases, Nanaimo Regional Hospital, Nanaimo, BC, Canada.
⁵ Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.

OBJECTIVE. The purpose of this study was to analyze the radiologic features of pulmonary Kaposi sarcoma–associated immune reconstitution syndrome. The syndrome is a phenomenon characterized by clinical deterioration of the condition of HIV-positive patients after initiation of highly active antiretroviral therapy.

MATERIALS AND METHODS. The study included four patients at our institution who fulfilled the diagnostic criteria for pulmonary Kaposi sarcoma–associated immune reconstitution syndrome from 2001 to 2006. All patients were men (mean age, 43 years; range, 31–59 years). Images reviewed included chest radiographs obtained before highly active antiretroviral therapy, radiographs and chest CT scans obtained at appearance of the symptoms of Kaposi sarcoma–associated immune reconstitution syndrome, and follow-up radiographs and chest CT scans during immune reconstitution syndrome.

RESULTS. The radiographic findings of Kaposi sarcoma–associated immune reconstitution syndrome included reticular and reticulonodular opacities (n = 4), areas of consolidation (n = 3), septal lines (n = 3), and pleural effusion (n = 3). The CT findings in all four patients were ill-defined pulmonary nodules and interlobular septal thickening. Three of the patients had a CT halo sign, areas of consolidation, ground-glass opacities, lymphadenopathy, and pleural effusion. The areas of consolidation in three subjects who did not receive chemotherapy increased markedly after 14–20 days. CT performed during the initial symptoms of immune reconstitution syndrome in these three subjects showed less than 5% parenchymal involvement. Follow-up CT showed 26–50% involvement in two patients and more than 50% involvement in one patient.

CONCLUSION. The radiologic findings of pulmonary Kaposi sarcoma–associated immune reconstitution syndrome are similar to the findings described in patients with Kaposi sarcoma without the syndrome, but the extent of abnormalities tends to increase with the development of the syndrome.

Keywords: AIDS • cancer • CT • Kaposi sarcoma • lung disease

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?