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