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Immune reconstitution inflammatory syndrome associated with acquired immunodeficiency syndrome-related gastrointestinal limited Kaposi's sarcoma presenting as acute intestinal obstruction: a case report

Jyotirmoy Pal1, Ankit Shrivastav2*, Hari Shankar Pathak3 and Dipendra Kumar Sarkar4

Author Affiliations

1 Associate Professor, Department of Medicine, Institute of Postgraduate Medical Education & Research, Kolkata, West Bengal, India

2 RMO cum Clinical Tutor, Department of Medicine, Institute of Postgraduate Medical Education & Research, Kolkata, India

3 Associate Professor, Department of Medicine, KPC Medical College & Hospital, Kolkata, India

4 Associate Professor, Department of Surgery, Institute of Postgraduate Medical Education & Research, Kolkata, India

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Journal of Medical Case Reports 2011, 5:327  doi:10.1186/1752-1947-5-327

Published: 26 July 2011

Abstract

Introduction

Immune reconstitution inflammatory syndrome during anti-retroviral treatment of acquired immunodeficiency syndrome (AIDS) -associated gastrointestinal Kaposi's sarcoma has rarely been reported.

Case Presentation

A 36-year-old Asian Indian male, newly diagnosed with AIDS and treatment naïve, was started on highly active antiretroviral therapy (HAART). He developed acute intestinal obstruction after four weeks of therapy. A laparotomy was done with excision and adhesiolysis leading to relief of symptoms. A histology report revealed the lesion to be Kaposi's sarcoma. Our patient was diagnosed to be having immune reconstitution inflammatory syndrome associated with AIDS-associated gastrointestinal limited Kaposi's sarcoma, which presented as acute intestinal obstruction. Our patient was treated with paclitaxel post-operatively and HAART was continued. Our patient responded to therapy.

Conclusion

Immune reconstitution inflammatory syndrome involving Kaposi's sarcoma may occur in HAART-naïve individuals with AIDS-related Kaposi's sarcoma. Gastrointestinal Kaposi's sarcoma may present with sudden increase in size or inflammation leading to acute intestinal obstruction. This does not indicate failure of HAART or a need for changes in anti-retroviral regimen.