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

Abstract

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 coinfection. Here, we describe an HIV/AIDS patient coinfected with disseminated 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.

Granulomatous interstitial nephritis in the setting of disseminated Mycobacterium simiae: a rare presentation of immune reconstitution inflammatory syndrome

“…[2][3][4] IRIS in the setting of disseminated M. simiae infection has been reported, presenting with pulmonary and central nervous system involvement. 5,6 Our case is only the third reported case of GIN associated with IRIS in the setting of disseminated NTM infection, 7,8 and the first reported due to M. simiae.…”

Interferon-gamma Release Assay-positive Granulomatous Interstitial Nephritis in a Patient with a History of Diffuse Large B Cell Lymphoma

“…An IGRA is also positive for some nontuberculous mycobacteria (NTM) infections. In addition, GIN has been reported to be caused by NTM (21)(22)(23)(24)(25). Most cases were associated with human immunodeficiency virus (HIV) infection or the use of immunosuppressive drugs.…”

Laryngeal Inflammatory Pseudotumour Secondary to Mycobacterium kansasii

“…Mycobacterium kansasii is an acid-fast bacillus that causes pulmonary and extrapulmonary disease in immunocompromised patients, such as in HIV [ 8 ], type 2 diabetes [ 9 ], and organ-transplanted individuals [ 10 ]. It is also the commonest nontuberculous mycobacterium causing pulmonary infection in the UK [ 11 ].…”