Evolving spectrum of HIV-associated nephropathy

Nephron Clin Pract. 2012;121(3-4):c131-5. doi: 10.1159/000345505. Epub 2012 Nov 30.

Abstract

Background: The profile of renal pathology in HIV patients is undergoing significant changes in pattern in the HAART era, with the incidence of HIV-associated nephropathy (HIVAN) decreasing and the incidence of non-HIVAN lesions increasing.

Case reports: We describe 2 cases of HIV-infected patients diagnosed with diffuse infiltrative lymphocytosis syndrome (DILS) and coexistent multiple myeloma, an association that has heretofore been unreported. The cases involve a 23-year-old man and a 54-year-old man who presented with renal failure and proteinuria. Kidney biopsy in both revealed DILS and further evaluation revealed both to have multiple myeloma.

Conclusion: DILS is a late complication of AIDS that has become extremely rare in the United States during the HAART era. However, there are patients who present without an AIDS-defining illness or cancers. The development of multiple myeloma in the setting of HIV and DILS presents a novel, heretofore unreported association that may be important to recognize in HIV/AIDS patients with kidney failure.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Associated Nephropathy / complications*
  • AIDS-Associated Nephropathy / diagnosis*
  • Diagnosis, Differential
  • Humans
  • Lymphocytosis / complications*
  • Lymphocytosis / diagnosis*
  • Male
  • Middle Aged
  • Multiple Myeloma / complications*
  • Multiple Myeloma / diagnosis*
  • Young Adult