PMID- 38521838
OWN - NLM
STAT- Publisher
LR  - 20240324
IS  - 1439-0973 (Electronic)
IS  - 0300-8126 (Linking)
DP  - 2024 Mar 23
TI  - Hypercalcemia as a rare manifestation of immune reconstitution inflammatory 
      syndrome (IRIS) in a person living with Human Immunodeficiency Virus (HIV) with 
      disseminated nontuberculous mycobacteriosis.
LID - 10.1007/s15010-024-02228-7 [doi]
AB  - INTRODUCTION: Granulomatosis due to immune reconstitution inflammatory syndrome 
      (IRIS) and disseminated Mycobacterium avium-intracellulare (M. avium) infection 
      may trigger hypercalcemia. Here, we report a rare case of hypercalcemia and acute 
      kidney damage related to IRIS in a person living with Human Immunodeficiency 
      Virus (HIV). CASE PRESENTATION: A 39-year-old male person living with HIV 
      presented with muscle weakness and unwanted weight loss of 8 kg within the last 
      2 weeks. Laboratory findings included serum hypercalcemia of 3.27 mmol/mL 
      associated with elevated calcitriol and acute kidney damage. Since the first 
      diagnosis of HIV and concomitant disseminated M. avium infection, the patient 
      received antiretroviral therapy (ART), rifabutin, clarithromycin, and ethambutol. 
      (18)Fluoro-D-glucose positron emission computed tomography ((18)FDG-PET/CT) 
      showed progressive multilocular lymphadenopathy. Biopsy specimen from the 
      duodenum as well as retroperitoneal and mediastinal lymph nodes revealed 
      granulomatous inflammation consistent with IRIS. Treatment with forced diuresis, 
      bisphosphonates, and calcitonin normalized serum calcium and kidney function 
      recovered. CONCLUSION: Hypercalcemia due to IRIS is a rare differential diagnosis 
      in persons living with HIV and may lead to acute kidney damage, despite 
      sufficient ART and antimycobacterial treatment.
CI  - (c) 2024. The Author(s).
FAU - Webendoerfer, Maximilian
AU  - Webendoerfer M
AD  - Department of Medical Oncology, West German Cancer Center, University Hospital 
      Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. 
      maximilian.webendoerfer@uk-essen.de.
AD  - Department of Infectious Diseases, West German Center of Infectious Diseases, 
      Essen University Hospital, University of Duisburg-Essen, Hufelandstrasse 55, 
      45147, Essen, Germany. maximilian.webendoerfer@uk-essen.de.
FAU - Konik, Margarethe
AU  - Konik M
AD  - Department of Infectious Diseases, West German Center of Infectious Diseases, 
      Essen University Hospital, University of Duisburg-Essen, Hufelandstrasse 55, 
      45147, Essen, Germany.
FAU - Zettler, Markus
AU  - Zettler M
AD  - Department of Infectious Diseases, West German Center of Infectious Diseases, 
      Essen University Hospital, University of Duisburg-Essen, Hufelandstrasse 55, 
      45147, Essen, Germany.
FAU - Wienker, Johannes
AU  - Wienker J
AD  - Department of Pneumology, University Hospital Essen - Ruhrlandklinik, University 
      of Duisburg-Essen, Tuschener Weg 40, 45239, Essen, Germany.
FAU - Rawitzer, Josefine
AU  - Rawitzer J
AD  - Institute for Pathology and Neuropathology, University Hospital Essen, University 
      of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.
FAU - Esser, Stefan
AU  - Esser S
AD  - Department of Dermatology and Venereology, HIV Outpatient Clinic, University 
      Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, 
      Germany.
FAU - Kehrmann, Jan
AU  - Kehrmann J
AD  - Institute of Medical Microbiology, University Hospital Essen, University of 
      Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.
FAU - Herrmann, Ken
AU  - Herrmann K
AD  - Department of Nuclear Medicine, University Hospital Essen, University of 
      Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.
FAU - Reinhardt, Hans Christian
AU  - Reinhardt HC
AD  - Department of Hematology and Stem Cell Transplantation, University Hospital 
      Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.
FAU - Witzke, Oliver
AU  - Witzke O
AD  - Department of Infectious Diseases, West German Center of Infectious Diseases, 
      Essen University Hospital, University of Duisburg-Essen, Hufelandstrasse 55, 
      45147, Essen, Germany.
FAU - Dolff, Sebastian
AU  - Dolff S
AD  - Department of Infectious Diseases, West German Center of Infectious Diseases, 
      Essen University Hospital, University of Duisburg-Essen, Hufelandstrasse 55, 
      45147, Essen, Germany.
LA  - eng
PT  - Journal Article
DEP - 20240323
PL  - Germany
TA  - Infection
JT  - Infection
JID - 0365307
SB  - IM
OTO - NOTNLM
OT  - Mycobacterium avium-intracellulare
OT  - Acute kidney damage
OT  - DLBCL
OT  - HIV
OT  - Hypercalcemia
OT  - IRIS
EDAT- 2024/03/24 06:42
MHDA- 2024/03/24 06:42
CRDT- 2024/03/24 00:21
PHST- 2024/02/02 00:00 [received]
PHST- 2024/03/05 00:00 [accepted]
PHST- 2024/03/24 06:42 [medline]
PHST- 2024/03/24 06:42 [pubmed]
PHST- 2024/03/24 00:21 [entrez]
AID - 10.1007/s15010-024-02228-7 [pii]
AID - 10.1007/s15010-024-02228-7 [doi]
PST - aheadofprint
SO  - Infection. 2024 Mar 23. doi: 10.1007/s15010-024-02228-7.