We describe the case of a newly diagnosed HIV-1-positive man who was noted to have asymptomatic HIV-related idiopathic (immune) thrombocytopaenic purpura. On commencing antiretroviral therapy we believe he experienced an uncommon immune reconstitution phenomenon resulting in the rapid worsening of his thrombocytopenia, requiring steroid therapy which stabilized his platelet levels.
KaslowRA, PhairJP, FriedmanHB, Infection with the human immunodeficiency virus: clinical manifestations and their relationship to immune deficiency. A report from the Multicenter AIDS Cohort Study. Ann Intern Med1987;107:474–80
2.
SloandE. Hematologic complications of HIV infection. Aids Rev2005;7:187–96
3.
BallemP, BelzbergA, DevineD, Kinetic studies of the mechanism of thrombocytopenia in patients with HIV infection. N Engl J Med1992;327:1779–84
4.
British Committee for Standards in Haematology General Haematology Task Force. Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children and in pregnancy. Br J Haematol2003;120:574–96
5.
BarbuiT, CortelazzoS, MinettiB, Does splenectomy enhance risk of AIDS in HIV-positive patients with chronic thrombocytopenia?Lancet1987;2:342–43
6.
MurdochDM, VenterWDF, Van RieA, Immune reconstitution inflammatory syndrome (IRIS): review of common infectious manifestations and treatment options. Aids Res Ther2007;4:9
7.
SerrtiI, SarlisNJ, AriogluE, Alopecia universalis and Graves' disease in the setting of immune restoration after highly active antiretroviral therapy. Aids2001;15:138–40
8.
CalbreseLH, KirchnerE, ShresthaR. Rheumatic complications of human immunodeficiency virus infection in the era of highly active antiretroviral therapy: emergence of a new syndrome of immune reconstitution and changing patterns of disease. Semin Arthritis Rheum2005;35:166–74
