Vasculitis: an unusual manifestation in an HIV-infected patient

Abstract

Human immunodeficiency virus (HIV) positive patients may develop vasculitis, either mediated by immunological factors or by direct vascular injury. We describe a patient who developed manifestations suggestive of extremities vasculitis with no identifiable risk factors other than HIV, Epstein Barr and Herpes Simplex Virus (HSV) type 1 co-infection. Physicians should be aware that vasculitis may have a heterogeneous presentation and occur associated with HIV infection. Although unusual, this association should be recognized for early proper treatment and prevention of ischemia.

A Case of Human Immunodeficiency Virus-Positive Patient Diagnosed during the Treatment of Right Internal Iliac Pseudoaneurysm

“…There have been a few reports of HIV-related vasculitis as a complication of HIV infection, mainly from African countries [2][3][4][5][6][7][8] ; we could not find any case reports from Japan. However, the Japanese Ministry of Health, Labour and Welfare statistics shows an increasing trend in the number of new HIV infections and AIDS patients, which is similar to the increasing trend across East Asia.…”

“…It is more common in immunosuppressed states when the CD4 T lymphocyte count is <200/mL. 2) The onset mechanism of HIV-related vasculitis is thought to involve not only direct invasion of blood vessels or immunological elements but also (1) pathogenassociated molecular pattern molecules produced from intestinal microorganisms that act on immune cells to create a chronic inflammatory state that causes endothelial damage and (2) oxidative stress associated with an infection that produces oxidized low-density lipoprotein that acts on immune cells to produce endothelial damage and chronic inflammation, and the combination of the above is thought to cause intravascular atherosclerosis. 3) The inflammation in HIV-related vasculitis mainly occurs in the tunica adventitia, which causes aneurysms and vascular blockage.…”

Clash of the -itises: An Unexpected Case of Sigmoid Colon Vasculitis

“…It can be secondary to direct vascular insult or immunologically mediated and most frequently occurs in severe immunocompromised patients (CD4 count ,200 cells/mL), associated with opportunistic infections (including hepatitis, HTLV-1, CMV, tuberculosis, parvovirus, syphilis) or in the absence of identifiable causes. [9][10][11] In this case, the pathology reported a predominantly lymphocytic vasculitis of the mesenteric and intramural arteries, which are middle-sized vessels. The vascular inflammation raises the possibility of systemic vasculitis such as idiopathic polyarteritis nodosa (PAN), a middle-sized vessel disease.…”

Spontaneous chronic subdural hematomas in human immunodeficiency virus-infected patients with normal platelet count and no appreciable brain atrophy: Two case reports and review of literature

“…In some cases, high immunoglobulin proteins are believed to interfere with coagulation factors leading to hemorrhage. [ 3 7 10 ]…”