An atypical pneumonia

Area of Science:

• Nephrology
• Rheumatology
• Infectious Diseases

Background:

• Human immunodeficiency virus (HIV) infection is associated with various autoimmune phenomena.
• Vasculitis, particularly small-vessel vasculitis, is an uncommon complication in HIV-positive individuals.

Observation:

• A patient with known HIV presented with severe respiratory distress and acute kidney injury.
• Clinical presentation and diagnostic workup led to a diagnosis of microscopic polyangiitis.

Findings:

• The patient received induction immunosuppression including plasma exchange and corticosteroids, followed by maintenance therapy with cyclophosphamide.
• Renal replacement therapy was initiated for acute renal failure.
• The patient achieved remission of microscopic polyangiitis symptoms.

Implications:

• This is the first reported case of microscopic polyangiitis in the context of HIV.
• The case suggests a potential link between HIV and the development of vasculitis, warranting further investigation.
• Understanding this association may inform future diagnostic and therapeutic strategies for HIV-associated autoimmune diseases.