Lymphadenopathy after Initiating HAART in an HIV-positive Patient with Kaposi's Sarcoma: a Case of Multicentric Castleman's Disease
  • Daniel Micallef
    Department of Medicine, Mater Dei Hospital, Msida
  • Jason Attard
    Department of Pathology, Mater Dei Hospital, Msida
  • Charles Mallia Azzopardi
    Department of Medicine, Mater Dei Hospital, Msida
  • Michael John Boffa
    Department of Dermatology, Sir Paul Boffa Hospital, Floriana


Castleman's disease, Kaposi's sarcoma, immune reconstitution inflammatory syndrome


We present the case of a 33-year-old lady who was diagnosed with disseminated Kaposi’s sarcoma and HIV infection. The patient improved on highly active antiretroviral therapy (HAART), however, nine days into treatment, she became febrile and dyspnoeic and developed tender cervical and axillary lymphadenopathy. Despite treatment for suspected sepsis and immune reconstitution, she died in intensive care. Lymph node biopsies revealed coexistent Castleman’s disease and Kaposi’s sarcoma.

Initiation of HAART can be rarely associated with unmasking and rapid progression of Castleman’s disease, a phenomenon called immune reconstitution. Urgent investigation and treatment with agents such as steroids and cytotoxic drugs can be life-saving.



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    Published: 2015-10-07
    Issue: Vol. 2 No. 7 (2015) (view)

    How to cite:
    Micallef D, Attard J, Mallia Azzopardi C, Boffa MJ. Lymphadenopathy after Initiating HAART in an HIV-positive Patient with Kaposi’s Sarcoma: a Case of Multicentric Castleman’s Disease. EJCRIM 2015;2 doi:10.12890/2015_00251.

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