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A Blast From the Past: Abdominal Wall Amyloidosis Due to Enfuvirtide Injections

Enfuvirtide was the first marketed fusion inhibitor that worked by binding to glycoprotein 41 of the HIV envelope, preventing the conformational changes required for HIV fusion with CD4+ T cells. Due to its novel mechanisms of action, it was frequently used in the past as part of regimens for the in...

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Autores principales: Costiniuk, Cecilia, Bourgault, Anne-Marie, Maedler-Kron, Chelsea, Feldman, Liane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483575/
https://www.ncbi.nlm.nih.gov/pubmed/37692653
http://dx.doi.org/10.7759/cureus.43126
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author Costiniuk, Cecilia
Bourgault, Anne-Marie
Maedler-Kron, Chelsea
Feldman, Liane
author_facet Costiniuk, Cecilia
Bourgault, Anne-Marie
Maedler-Kron, Chelsea
Feldman, Liane
author_sort Costiniuk, Cecilia
collection PubMed
description Enfuvirtide was the first marketed fusion inhibitor that worked by binding to glycoprotein 41 of the HIV envelope, preventing the conformational changes required for HIV fusion with CD4+ T cells. Due to its novel mechanisms of action, it was frequently used in the past as part of regimens for the indication of multi-class-resistant HIV until newer oral agents emerged. Here, we describe the case of a 40-year-old man who used enfuvirtide injections from 2012 to 2017 inclusive for multi-class-resistant HIV until he presented in 2021 with an abscess overlying a right lower quadrant mass requiring drainage via pigtail. Congo red stain of the tissue showed positive apple green birefringence on amorphous material after polarization, enabling the diagnosis of enfuvirtide-induced amyloidosis. The patient experienced significant improvement following surgical excision of the cysts and nodules. This case demonstrates that sequelae of injection site reactions can persist for many years following the cessation of enfuvirtide injections.
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spelling pubmed-104835752023-09-08 A Blast From the Past: Abdominal Wall Amyloidosis Due to Enfuvirtide Injections Costiniuk, Cecilia Bourgault, Anne-Marie Maedler-Kron, Chelsea Feldman, Liane Cureus Internal Medicine Enfuvirtide was the first marketed fusion inhibitor that worked by binding to glycoprotein 41 of the HIV envelope, preventing the conformational changes required for HIV fusion with CD4+ T cells. Due to its novel mechanisms of action, it was frequently used in the past as part of regimens for the indication of multi-class-resistant HIV until newer oral agents emerged. Here, we describe the case of a 40-year-old man who used enfuvirtide injections from 2012 to 2017 inclusive for multi-class-resistant HIV until he presented in 2021 with an abscess overlying a right lower quadrant mass requiring drainage via pigtail. Congo red stain of the tissue showed positive apple green birefringence on amorphous material after polarization, enabling the diagnosis of enfuvirtide-induced amyloidosis. The patient experienced significant improvement following surgical excision of the cysts and nodules. This case demonstrates that sequelae of injection site reactions can persist for many years following the cessation of enfuvirtide injections. Cureus 2023-08-08 /pmc/articles/PMC10483575/ /pubmed/37692653 http://dx.doi.org/10.7759/cureus.43126 Text en Copyright © 2023, Costiniuk et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Costiniuk, Cecilia
Bourgault, Anne-Marie
Maedler-Kron, Chelsea
Feldman, Liane
A Blast From the Past: Abdominal Wall Amyloidosis Due to Enfuvirtide Injections
title A Blast From the Past: Abdominal Wall Amyloidosis Due to Enfuvirtide Injections
title_full A Blast From the Past: Abdominal Wall Amyloidosis Due to Enfuvirtide Injections
title_fullStr A Blast From the Past: Abdominal Wall Amyloidosis Due to Enfuvirtide Injections
title_full_unstemmed A Blast From the Past: Abdominal Wall Amyloidosis Due to Enfuvirtide Injections
title_short A Blast From the Past: Abdominal Wall Amyloidosis Due to Enfuvirtide Injections
title_sort blast from the past: abdominal wall amyloidosis due to enfuvirtide injections
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483575/
https://www.ncbi.nlm.nih.gov/pubmed/37692653
http://dx.doi.org/10.7759/cureus.43126
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