PMID- 30904896
OWN - NLM
STAT- MEDLINE
DCOM- 20190723
LR  - 20231011
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 12
IP  - 3
DP  - 2019 Mar 22
TI  - Chylous ascites in disseminated Kaposi sarcoma: an unusual manifestation as 
      immune reconstitution inflammatory syndrome.
LID - 10.1136/bcr-2018-228406 [doi]
LID - e228406
AB  - A 29-year-old man with diarrhoea, fever, abdominal pain and multiple purple 
      papular lesions, neither pruriginous nor painful, was diagnosed with HIV-1 
      infection and disseminated Kaposi sarcoma (KS) with gastrointestinal involvement. 
      He was started on highly active antiretroviral therapy immediately, as well as 
      doxorubicin. Three weeks later, the patient developed bilateral moderate pleural 
      effusion and large-volume ascites compatible with chylothorax and chylous 
      ascites. An immune reconstitution inflammatory syndrome (IRIS) reaction was 
      assumed. KS flare was associated with lymphatic obstruction and infiltration of 
      thoracic duct by the tumour itself with leakage of chylous into pleural and 
      peritoneal cavities. KS is the most common tumour in HIV patients and the 
      existence of related effusions is not uncommon. KS-related chylothorax is an 
      unusual manifestation of KS; there are only four cases described in the 
      literature of chylous ascites related to KS-HIV. Overall survival is improving in 
      KS but explosive and debilitating IRIS reactions can explain cases with poor 
      prognosis.
CI  - (c) BMJ Publishing Group Limited 2019. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Cipriano, Patricia
AU  - Cipriano P
AUID- ORCID: 0000-0002-0222-2171
AD  - Department of Internal Medicine, Hospital de Cascais, Cascais, Portugal.
FAU - Nabais, Ines
AU  - Nabais I
AD  - Department of Internal Medicine, Hospital de Cascais, Cascais, Portugal.
FAU - Melo, Nuno
AU  - Melo N
AD  - Department of Internal Medicine, Hospital de Cascais, Cascais, Portugal.
FAU - Alves, Ana Rafaela
AU  - Alves AR
AD  - Department of Internal Medicine, Hospital de Cascais, Cascais, Portugal.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20190322
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 0 (liposomal doxorubicin)
RN  - 3WJQ0SDW1A (Polyethylene Glycols)
RN  - 80168379AG (Doxorubicin)
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Chylous Ascites/*diagnostic imaging
MH  - Diagnosis, Differential
MH  - Doxorubicin/administration & dosage/analogs & derivatives/therapeutic use
MH  - HIV Infections/complications/diagnosis/*drug therapy
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/diagnostic imaging
MH  - Male
MH  - Polyethylene Glycols/administration & dosage/therapeutic use
MH  - Prognosis
MH  - Sarcoma, Kaposi/*complications/drug therapy/etiology
MH  - Sexual and Gender Minorities
MH  - Tomography, X-Ray Computed
PMC - PMC6510130
OTO - NOTNLM
OT  - HIV/aids
OT  - haematology (incl blood transfusion)
COIS- Competing interests: None declared.
EDAT- 2019/03/25 06:00
MHDA- 2019/07/25 06:00
PMCR- 2021/03/22
CRDT- 2019/03/25 06:00
PHST- 2019/03/25 06:00 [entrez]
PHST- 2019/03/25 06:00 [pubmed]
PHST- 2019/07/25 06:00 [medline]
PHST- 2021/03/22 00:00 [pmc-release]
AID - 12/3/e228406 [pii]
AID - bcr-2018-228406 [pii]
AID - 10.1136/bcr-2018-228406 [doi]
PST - epublish
SO  - BMJ Case Rep. 2019 Mar 22;12(3):e228406. doi: 10.1136/bcr-2018-228406.