Occlusive vasculopathy in human immunodeficiency virus (HIV)-associated vasculitis: unusual clinical and imaging course

Human immunodeficiency virus (HIV)-associated vasculitis is a rare secondary systemic vasculitis involving small and medium arteries. We report a 42-year-old man with uncontrolled HIV infection presenting with long-lasting abdominal pain. An abdominal CT angiography revealed multiple microaneurysms...

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Bibliographic Details
Published in:Clinical and experimental rheumatology 2017-03, Vol.35 Suppl 103 (1), p.185-188
Main Authors: Ripoll, Enric, Prieto-González, Sergio, Balagué, Olga, Marco-Hernández, Javier, Miró, Josep M, Darnell, Anna, Cid, Maria C, Hernández-Rodríguez, José
Format: Article
Language:English
Subjects:
Abdominal Pain - etiology
Adult
Aneurysm - diagnostic imaging
Aneurysm - etiology
Aneurysm - immunology
Aneurysm - therapy
Biopsy
Computed Tomography Angiography
Glucocorticoids - therapeutic use
Hepatic Artery - diagnostic imaging
HIV Infections - complications
HIV Infections - diagnosis
HIV Infections - drug therapy
HIV Infections - immunology
HIV Integrase Inhibitors - therapeutic use
Humans
Immunocompromised Host
Male
Mesenteric Arteries - diagnostic imaging
Mesenteric Ischemia - diagnostic imaging
Mesenteric Ischemia - etiology
Mesenteric Ischemia - immunology
Mesenteric Ischemia - therapy
Mesenteric Vascular Occlusion - diagnostic imaging
Mesenteric Vascular Occlusion - etiology
Mesenteric Vascular Occlusion - immunology
Mesenteric Vascular Occlusion - therapy
Raltegravir Potassium - therapeutic use
Remission Induction
Renal Artery - diagnostic imaging
Systemic Vasculitis - diagnostic imaging
Systemic Vasculitis - etiology
Systemic Vasculitis - immunology
Systemic Vasculitis - therapy
Time Factors
Treatment Outcome
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Summary:Human immunodeficiency virus (HIV)-associated vasculitis is a rare secondary systemic vasculitis involving small and medium arteries. We report a 42-year-old man with uncontrolled HIV infection presenting with long-lasting abdominal pain. An abdominal CT angiography revealed multiple microaneurysms and stenoses in intrarenal arteries, with involvement of mesenteric and hepatic arteries. HIV-associated vasculitis was diagnosed and glucocorticoids and raltegravir-based antiretroviral therapy were administered with good initial clinical and virological response. Several episodes of acute intestinal ischaemia were later developed requiring bowel resections of which histological examination showed vascular occlusive fibrotic changes without active vasculitic lesions. Vasculitis persisted in remission and intrarenal microaneurysms disappeared.
ISSN:0392-856X