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Immune reconstitution inflammatory syndrome manifesting as development of multiple autoimmune disorders and skin cancer progression
Author(s) -
McLeod D. S. A.,
Woods M. L.,
Kandiah D. A.
Publication year - 2011
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2011.02546.x
Subject(s) - medicine , rheumatoid arthritis , malignancy , immunology , autoimmunity , immune system , genetic predisposition , cancer , arthritis , pathology , disease
We report the case of a 56‐year‐old man with the rare autoimmune pathologies of alternating hypothyroidism and hyperthyroidism due to thyroid‐stimulating hormone receptor antibodies, and rheumatoid arthritis as manifestations of a human immunodeficiency virus‐related immune reconstitution inflammatory syndrome. The patient also developed overt progression of a pre‐existing skin malignancy that may also be related. This case highlights immune reconstitution syndrome as an important differential diagnosis following antiretroviral therapy commencement, and that a high index of suspicion should be maintained for this rare but important cluster of conditions. Furthermore, the patient's genetic predisposition to autoimmunity provides helpful insights into the pathogenesis of these disorders.