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Lymphocytic bronchiolitis associated with HIV infection.
D B Ettensohn1, K H Mayer, N Kessimian
1Department of Medicine, Memorial Hospital, Pawtucket, RI 02860.
Chest
|January 1, 1988
Summary
Patients with acquired immune deficiency syndrome (AIDS) may develop lymphocytic bronchiolitis, a potential new lung manifestation of HIV infection. This finding suggests a broader spectrum of pulmonary disease beyond interstitial lung disease in individuals with HIV.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Immunology
Background:
- Acquired immune deficiency syndrome (AIDS) patients commonly experience interstitial lung disease, often from opportunistic infections.
- Airways disease in HIV-infected individuals is less frequently reported.
- Previous associations include malignancy and lymphocytic interstitial pneumonitis.
Observation:
- A patient with AIDS-related complex presented with symptoms and imaging suggestive of micronodular interstitial lung disease.
- Transbronchial biopsy showed lymphocytic bronchiolitis without interstitial lung disease.
- Bronchoalveolar lavage revealed a significant T-suppressor lymphocytosis.
Findings:
- Standard cultures for fungi, viruses, and bacteria were negative.
- The case suggests lymphocytic bronchiolitis as a potential pulmonary manifestation of HIV infection.
- This contrasts with typical interstitial lung disease presentations in AIDS.
Implications:
- Highlights the need to consider lymphocytic bronchiolitis in the differential diagnosis of pulmonary symptoms in HIV patients.
- Suggests HIV itself may directly affect the airways, not just cause opportunistic infections.
- Warrants further research into the pathogenesis and clinical significance of HIV-associated bronchiolitis.