Allergic Granulomatosis and Angiitis of Churg‐Strauss Case Report in a Patient with Antibodies to Human Immunodeficiency Virus and Hepatitis B Virus

Cooper, Lauren M.; Patterson, Jennifer

doi:10.1111/j.1365-4362.1989.tb02536.x

Cited by 27 publications

(3 citation statements)

References 3 publications

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“…However, from a total of 94 patients with HIV infection who tested positive for ANCA in three separate series, only one was found to have clinical vasculitis 3–5. There have been sporadic reports of clinical vasculitis in patients with HIV infection, two with ANCA-negative eosinophilic granulomatosis with polyangiitis (formely Churg Strauss Syndrome),6 7 one of which was in association with a new diagnosis of HIV7; however, the first probable report of ANCA-positive vasculitis in HIV was of a patient with a clinical diagnosis of granulomatosis with polyangiitis (formerly Wegener's) but lacked histological confirmation of vasculitis 5. The authors of this case subsequently reviewed patients from a Dutch HIV registry and identified only one patient with GN of unknown cause.…”

Section: Discussionmentioning

confidence: 99%

ANCA-associated vasculitis and pauci-immune glomerulonephritis in HIV disease

Evans¹,

Gueret-Wardle²,

Edwards

et al. 2014

BMJ Case Reports

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We report the case of a 51-year-old African woman with longstanding well-controlled HIV who developed relapsing systemic antineutrophil cytoplasm antibody (ANCA)-associated vasculitis and glomerulonephritis. She presented with an acute kidney injury and heavy proteinuria in the setting of a prolonged history of diffuse arthralgias and transient ocular symptoms. Antimyeloperoxidase (MPO) antibody titre was >100 IU/mL. Subsequent renal biopsy demonstrated a focal necrotising pauci-immune glomerulonephritis and a diagnosis of MPO-ANCA-associated microscopic polyangiitis was made. The patient was treated with tapering glucocorticoids and rituximab with resolution of her acute kidney injury and reduction in her proteinuria. Treatment was complicated by the development of steroid-induced diabetes and one mild clinical relapse, but was otherwise well tolerated without infectious complications or deterioration in her HIV disease.

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Section: Discussionmentioning

confidence: 99%

ANCA-associated vasculitis and pauci-immune glomerulonephritis in HIV disease

Evans¹,

Gueret-Wardle²,

Edwards

et al. 2014

BMJ Case Reports

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“…Causes in HIV infected patients include Churg–Strauss syndrome (CSS), Takayasu arteritis, polyarteritis nodosa (PAN) and certain infections, including HIV 72 73. Shave biopsies or superficial punch biopsies from cases of CSS or PAN may reveal only small vessel LCV involving vessels in the upper dermis 59.…”

Section: Diagnostic Approachmentioning

confidence: 99%

The HIV-positive skin biopsy

Grayson¹

2007

J Clin Pathol

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Dermatological disorders are a frequent presenting feature of HIV infection and/or AIDS. More than 90% of HIV-infected patients will suffer from one or more skin diseases during the course of their illness. This trend is reflected in the increasing number of skin biopsies from HIV-positive patients in those parts of the world where HIV infection/AIDS is highly prevalent. Histopathologists are therefore required to possess a working knowledge of the broad spectrum of cutaneous manifestations of HIV infection. These include the range of dermatoses that are specific to HIV infection, the more common dermatoses occurring with greater frequency (or modified by) HIV infection/AIDS, the spectrum of infectious diseases (often opportunistic) caused by viruses, bacteria, fungi, protozoa and even arthropods, and neoplastic conditions such as Kaposi sarcoma and B-cell non-Hodgkin lymphoma. The risk for adverse skin reactions to certain drugs is also greatly increased. Although the introduction of highly active antiretroviral therapy has resulted in a dramatic decrease in opportunistic infections, several of these drugs may result in adverse reactions in the skin. Skin biopsies play a vital diagnostic role when different diseases present with clinically similar skin lesions. Biopsy material should always be examined carefully to exclude dual pathology. The diagnosis may need to be confirmed with histochemical and immunohistochemical stains, and/or molecular studies. Where indicated, additional biopsies for microbiological culture should always be recommended. The examination of multiple serial sections often proves invaluable. A diagnostic approach is given based on the predominant histological reaction pattern, with an emphasis on clinicopathological correlation.

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“…Due to the rarity of CSS, the association between this disorder and viral infections has not been thoroughly investigated. However, the onset of CSS has been reported in a patient with HIV‐1 infection who also had antibodies to hepatitis B virus (156). In such a case, the vasculitis may occur as a result of a direct pathogenic effect of HIV‐1 infection on vascular tissues, or as a consequence of one of the many coinfections accompanying HIV‐1 infection in immunocompromised patients (148).…”

Section: Pathogenesismentioning

confidence: 99%