[A paradox: sarcoidosis in an HIV-positive patient]

Ned Tijdschr Geneeskd. 2015;159:A8353.
[Article in Dutch]


Background: In view of the diminished number of CD4+ lymphocytes, the co-existence of an HIV infection and sarcoidosis seems paradoxical. Immune reconstitution inflammatory syndrome (IRIS) may be observed in response to anti-retroviral therapy (ART). According to the conventional definition, this is caused by an overwhelming immune response to an already present or to a new agent.

Case description: We describe the case of a 47-year-old HIV-positive patient, who presented with an exacerbation of his sarcoidosis nine months after initiation of ART. Based on the time course and the dynamics of the CD4+ lymphocyte count, this presentation of disease can be placed in the context of IRIS.

Conclusion: The presentation or exacerbation of sarcoidosis after initiation of antiretroviral therapy in HIV-positive patients with a low CD4+ count at start of therapy can be placed in the context of IRIS.

Publication types

  • Case Reports

MeSH terms

  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count*
  • HIV Infections / epidemiology*
  • HIV Infections / immunology
  • Humans
  • Immune Reconstitution Inflammatory Syndrome / epidemiology*
  • Male
  • Middle Aged
  • Sarcoidosis / epidemiology*
  • Sarcoidosis / immunology