Unexplained lymphadenopathy in sickle cell disease

Area of Science:

• Infectious Diseases
• Hematology
• Immunology

Background:

• Sickle cell disease (SCD) is a genetic blood disorder affecting red blood cells.
• Patients with SCD may have altered immune function, but their susceptibility to certain infections is not fully understood.
• Progressive lymphadenopathy can indicate various underlying conditions, including infections.

Observation:

• A previously healthy adult female with homozygous SCD presented with progressive lymphadenopathy.
• Initial presentation mimicked other conditions, delaying the diagnosis of HIV infection.
• Thorough patient history revealed potential risk factors for HIV exposure.

Findings:

• The lymphadenopathy was definitively diagnosed as being caused by HIV infection.
• Identified risk factors included parenteral therapy and heterosexual contact during international travel.
• This case underscores that SCD patients, even those appearing low-risk, can be susceptible to HIV.

Implications:

• SCD patients require careful consideration of infectious disease risks, including HIV, especially when traveling or undergoing medical procedures abroad.
• Healthcare providers should maintain a high index of suspicion for opportunistic infections like HIV in SCD patients presenting with unexplained symptoms.
• Further research is needed to clarify the interplay between SCD-related immunological abnormalities and susceptibility to HIV infection.