An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids

A 60-year-old man was admitted to our hospital because of a persistent fever with enlargement of multiple lymph nodes in the mediastinum and around the pancreatic head. He was diagnosed with tuberculosis and human immunodeficiency virus infection. We started antiretroviral therapy three weeks after...

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Detalles Bibliográficos
Autores principales: Watanabe, Naoaki, Sato, Ryota, Nagai, Hideaki, Matsui, Hirotoshi, Yamane, Akira, Kawashima, Masahiro, Suzuki, Junko, Tashimo, Hiroyuki, Ohshima, Nobuharu, Masuda, Kimihiko, Tamura, Atsuhisa, Akagawa, Shinobu, Hebisawa, Akira, Ohta, Ken
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658536/
https://www.ncbi.nlm.nih.gov/pubmed/28883243
http://dx.doi.org/10.2169/internalmedicine.8713-16
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author Watanabe, Naoaki
Sato, Ryota
Nagai, Hideaki
Matsui, Hirotoshi
Yamane, Akira
Kawashima, Masahiro
Suzuki, Junko
Tashimo, Hiroyuki
Ohshima, Nobuharu
Masuda, Kimihiko
Tamura, Atsuhisa
Akagawa, Shinobu
Hebisawa, Akira
Ohta, Ken
author_facet Watanabe, Naoaki
Sato, Ryota
Nagai, Hideaki
Matsui, Hirotoshi
Yamane, Akira
Kawashima, Masahiro
Suzuki, Junko
Tashimo, Hiroyuki
Ohshima, Nobuharu
Masuda, Kimihiko
Tamura, Atsuhisa
Akagawa, Shinobu
Hebisawa, Akira
Ohta, Ken
author_sort Watanabe, Naoaki
collection PubMed
description A 60-year-old man was admitted to our hospital because of a persistent fever with enlargement of multiple lymph nodes in the mediastinum and around the pancreatic head. He was diagnosed with tuberculosis and human immunodeficiency virus infection. We started antiretroviral therapy three weeks after the initiation of anti-tuberculous therapy. Two weeks later, jaundice appeared with dilatation of the biliary tract due to further enlargement of the lymph nodes, which seemed to be immune reconstitution inflammatory syndrome (IRIS). The administration of corticosteroids resolved the obstructive jaundice without surgical treatment or endoscopic drainage. Obstructive jaundice caused by IRIS should first be treated with corticosteroids before invasive treatment.
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spelling pubmed-56585362017-10-27 An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids Watanabe, Naoaki Sato, Ryota Nagai, Hideaki Matsui, Hirotoshi Yamane, Akira Kawashima, Masahiro Suzuki, Junko Tashimo, Hiroyuki Ohshima, Nobuharu Masuda, Kimihiko Tamura, Atsuhisa Akagawa, Shinobu Hebisawa, Akira Ohta, Ken Intern Med Case Report A 60-year-old man was admitted to our hospital because of a persistent fever with enlargement of multiple lymph nodes in the mediastinum and around the pancreatic head. He was diagnosed with tuberculosis and human immunodeficiency virus infection. We started antiretroviral therapy three weeks after the initiation of anti-tuberculous therapy. Two weeks later, jaundice appeared with dilatation of the biliary tract due to further enlargement of the lymph nodes, which seemed to be immune reconstitution inflammatory syndrome (IRIS). The administration of corticosteroids resolved the obstructive jaundice without surgical treatment or endoscopic drainage. Obstructive jaundice caused by IRIS should first be treated with corticosteroids before invasive treatment. The Japanese Society of Internal Medicine 2017-09-06 2017-10-01 /pmc/articles/PMC5658536/ /pubmed/28883243 http://dx.doi.org/10.2169/internalmedicine.8713-16 Text en Copyright © 2017 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Watanabe, Naoaki
Sato, Ryota
Nagai, Hideaki
Matsui, Hirotoshi
Yamane, Akira
Kawashima, Masahiro
Suzuki, Junko
Tashimo, Hiroyuki
Ohshima, Nobuharu
Masuda, Kimihiko
Tamura, Atsuhisa
Akagawa, Shinobu
Hebisawa, Akira
Ohta, Ken
An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids
title An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids
title_full An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids
title_fullStr An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids
title_full_unstemmed An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids
title_short An HIV-positive Case of Obstructive Jaundice Caused by Immune Reconstitution Inflammatory Syndrome of Tuberculous Lymphadenitis Successfully Treated with Corticosteroids
title_sort hiv-positive case of obstructive jaundice caused by immune reconstitution inflammatory syndrome of tuberculous lymphadenitis successfully treated with corticosteroids
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658536/
https://www.ncbi.nlm.nih.gov/pubmed/28883243
http://dx.doi.org/10.2169/internalmedicine.8713-16
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