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  • First case of acute granulomatous interstitial nephritis with immune reconstitution inflammatory syndrome in a patient with HIV coinfected with disseminated Mycobacterium kansasii

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Rare disease
CASE REPORT
First case of acute granulomatous interstitial nephritis with immune reconstitution inflammatory syndrome in a patient with HIV coinfected with disseminated Mycobacterium kansasii
  1. Vikas Kapoor1,
  2. Azka Latif1,
  3. Faiza Hassan Warraich1,
  4. Aneela Majeed2
  1. 1Department of Hematology and Oncology, University of Arizona Arizona Health Sciences Center, Tucson, Arizona, USA
  2. 2Department of Infectious Diseases, University of Arizona Arizona Health Sciences Center, Tucson, Arizona, USA
  1. Correspondence to Dr Aneela Majeed, amajeed{at}deptofmed.arizona.edu

Summary

Restoration of immune response by highly active antiretroviral therapy (HAART) effectively improved the overall prognosis of HIV infection. However, 25%–31.7% of patients experience paradoxical worsening of pre-existing infections or unmasking of subclinical infections after starting HAART therapy, which is termed as immune reconstitution inflammatory syndrome (IRIS). Acute granulomatous interstitial nephritis as a consequence of IRIS has never been reported with Mycobacteriumkansasiicoinfection. Here, we describe an HIV/AIDS patient coinfected with disseminated M. kansasii infection, who presented with acute kidney injury 4.5 months after initiation of HAART. The diagnostic workup revealed IRIS was the cause of acute kidney injury. Short-term course of prednisone (1 mg/kg/day) along with antimycobacterial and HAART regimen achieved significant improvement.

  • infections
  • infectious diseases
  • immunology
  • acute renal failure

https://doi.org/10.1136/bcr-2017-222149

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    Footnotes

    • Contributors VK, AL and AM contributed to the concept and design and critical revision of the article. VK, AL, FHW and AM were responsible for the data analysis, interpretation and drafting of the article. All authors contributed to the final approval of the version to be published.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.