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Case Reports
. 2014 Jul;24(3):277-83.
doi: 10.4314/ejhs.v24i3.13.

HIV associated lupus like nephropathy

Changal Khalid Hamid  1 , Raina Abdul Hameed  1 , Baba Iqbal Khaliq  2 , Raina Manzoor  3 , Changal Qayum Hamid  4
Affiliations
Case Reports

HIV associated lupus like nephropathy

Changal Khalid Hamid et al. Ethiop J Health Sci. 2014 Jul.

Abstract

Background: Human immunodeficiency virus type 1 (HIV-1)-seropositive patients are at a high risk for the development of a variety of acute and chronic renal diseases. Most patients with HIVAN are of African descent, presenting late in the course of their HIV-1 infection. The only reliable test to establish or rule out the presence of HIVAN (HIV associated nephropathy) is renal biopsy. The most common lesion associated with HIV is a focal segmental glomeruloscelerosis, but several times, other biopsy findings may also be seen. Our patient had lupus nephritis like pathology picture. The therapeutic agents with the most promise are angiotensin-converting enzyme inhibitors and antiretroviral medications. Role of steroids are less well-defined although they have been used with success many times.

Case details: Our patient was a young male who presented with a pulmonary renal syndrome like picture and wasting. On evaluation, he was found to be HIV-1 positive, and renal biopsy showed lupus nephritis like pathological picture. The patient was treated with HAART (Highly active anti retroviral therapy) , steroids and ACE inhibitors and showed an excellent response.

Conclusion: The case highlights the fact that immune mediated glomerulonephritis, although rare, can be the presenting feature of HIV infection and can be controlled, if not cured, with proper treatment.

Keywords: Glomerulonephritis; HIV; HIV associated nephropathy.

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Figures

Figure 1
Figure 1
A histopathological picture showing mesangial and endocapillary glomerulonephritis
Figure 2
Figure 2
HRCT chest showing a left upper lobe consolidation
Figure 3
Figure 3
Image of the patient showing the emaciated appearance before the treatment
Figure 4
Figure 4
Image of the patient 12 months after treatment
See this image and copyright information in PMC

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