Abstract

BackgroundIdentifying and treating the cause of pulmonary symptoms in HIV patients with underlying systemic lupus erythematosus (SLE) can be very challenging. Delays in diagnosing active SLE in HIV patients can lead to significant morbidity and even mortality. We report the case of an HIV-positive woman with SLE who presented with severe respiratory distress.Case presentationA 42-year-old HIV-positive woman presented with a 7-month history of anorexia, progressive dyspnoea, and a productive cough. She had been put on treatment for pulmonary tuberculosis and pneumocystis jiroveci pneumonia for several months by the referring hospital without any significant improvement in her symptoms. Her initial laboratory investigations showed highly elevated d-dimer test results but confirmatory investigations for pulmonary embolism proved otherwise. An autoimmune screen revealed highly positive antinuclear antibody and anti-double-stranded DNA tests, and she responded very well to SLE treatment.ConclusionsOur case represents a situation where two diseases with antagonizing pathways of disease pathogenesis occur concurrently in the same patient. SLE is usually not among the differential diagnoses in HIV patients with respiratory distress. Management of patients with both SLE and HIV is also very challenging because improvement in one condition can lead to worsening of the other. Despite opportunistic infections being the likely cause of pulmonary symptoms in HIV patients, clinicians are encouraged to have a high index of suspicion for autoimmune interstitial lung disease in these patients.

Highlights

  • Identifying and treating the cause of pulmonary symptoms in human immunodeficiency virus (HIV) patients with underlying systemic lupus erythematosus (SLE) can be very challenging

  • Despite opportunistic infections being the likely cause of pulmonary symptoms in HIV patients, clinicians are encouraged to have a high index of suspicion for autoimmune interstitial lung disease in these patients

  • In an HIV-infected patient with some clinical and laboratory findings suggestive of pulmonary embolism (PE), it is even more difficult to entertain the possibility of SLE

Read more

Summary

Conclusions

Pulmonary manifestations are many and very common in HIV patients. Clinicians are encouraged to have a high index of suspicion for autoimmune interstitial lung disease in HIV patients presenting with pulmonary symptoms that cannot be explained by infectious causes or are recalcitrant to treatment for opportunistic infections. Authors’ contributions All authors contributed to the preparation of this manuscript. All authors read and approved the final manuscript. Author details 1 Department of Medicine, University Teaching Hospital, University of Zambia School of Medicine, Lusaka, Zambia. 2 Dermatology and Venereology Section, Department of Medicine, University Teaching Hospital, University of Zambia School of Medicine, Lusaka, Zambia

Background
Result
Discussion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call