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Am. J. Respir. Crit. Care Med., Volume 159, Number 6, June 1999, 2009-2013

Sarcoid-like Pulmonary Disorder in Human Immunodeficiency Virus-infected Patients Receiving Antiretroviral Therapy

JEAN-MARC NACCACHE, MARTINE ANTOINE, MARIE WISLEZ, JOCELYNE FLEURY-FEITH, ERIC OKSENHENDLER, CHARLES MAYAUD, and JACQUES CADRANEL

Services de Pneumologie et de Réanimation Respiratoire, d'Anatomie-Pathologique, et d'Histologie Biologie Tumorale, Hôpital Tenon, Paris; Service d'Immuno-Hématologie, Hôpital Saint-Louis, Paris; and Laboratoire de Biologie et d'Immunopathologie Pulmonaire, UPRES EA 1531, Université Paris VI, UFR Saint-Antoine, Paris, France

We report two cases of HIV-infected patients who presented with diffuse interstitial micronodular lesions on chest X-ray after institution of protease inhibitor-containing highly active antiretroviral therapy (HAART). Granulomatous pulmonary disorder mimicking sarcoidosis was diagnosed on histopathological studies revealing noncaseating granuloma and bronchoalveolar lavage analysis showing an intense CD4+ lymphocyte alveolitis. Causative agents such as infectious organisms and environmental compounds were excluded. The relationship between sarcoid-like reaction and immune reconstitution under HAART is discussed.




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