Tenosynovitis as a possible feature of immune reconstitution syndrome during highly active antiretroviral treatment (HAART)

Joint Bone Spine. 2009 Oct;76(5):550-2. doi: 10.1016/j.jbspin.2009.01.008. Epub 2009 Jun 11.

Abstract

An immune reconstitution syndrome (IRS) occurs in between 10% and 25% of patients starting highly active antiretroviral treatment (HAART). A 49-year-old patient presents a tenosynovitis 6 weeks after HAART initiation. In our patient, exhaustive tests for infectious, inflammatory and drug-related causes of tenosynovitis were negative. The improvement obtained with high-dose Non-steroidal anti-inflammatory-drug (NSAID) therapy and the patient's immunovirologic profile, supported a diagnosis of tenosynovitis associated with immune reconstitution, a form of IRS that has not previously been described. This original case increase the broad spectrum of inflammatory rheumatologic disorders associated with HIV infection.

Publication types

  • Case Reports

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antiretroviral Therapy, Highly Active / adverse effects*
  • CD4-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / immunology
  • Gadolinium
  • HIV Infections / drug therapy
  • HIV-1 / drug effects
  • Humans
  • Indomethacin / therapeutic use*
  • Inflammation / chemically induced
  • Male
  • Middle Aged
  • Radiography
  • Tenosynovitis / chemically induced*
  • Tenosynovitis / diagnostic imaging
  • Tenosynovitis / drug therapy
  • Tenosynovitis / immunology*
  • Viral Load

Substances

  • Anti-HIV Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Gadolinium
  • Indomethacin