Das Rama, Sarkar Somenath, Besra Mrinal
Department of Pathology, School of Tropical Medicine, Kolkata, West Bengal, India.
Indian J Sex Transm Dis AIDS. 2013 Jul;34(2):126-8. doi: 10.4103/0253-7184.120552.
Bullous disorders such as pemphigus vulgaris, bullous pemphigoid after the initiation of highly active antiretroviral therapy in certain human immunodeficiency virus reactive individuals have been described in this case series as a manifestation of an immune reconstitution inflammatory syndrome. This phenomenon should be suspected in individuals who present with bullous lesions within 3-8 weeks after initiation of therapy despite of improved immunological response. Strong clinical suspicion, through clinical examination, appropriate laboratory investigation such as CD4 T-cell count, histopathological examinations with H and E stain, direct immunofluorescence test are required for diagnosis.
在本病例系列中,已描述了某些人类免疫缺陷病毒反应性个体在开始高效抗逆转录病毒治疗后出现的大疱性疾病,如寻常型天疱疮、大疱性类天疱疮,作为免疫重建炎症综合征的一种表现。对于在治疗开始后3 - 8周内出现大疱性皮损,尽管免疫反应有所改善的个体,应怀疑这种现象。诊断需要通过临床检查进行强烈的临床怀疑,进行适当的实验室检查,如CD4 T细胞计数、苏木精和伊红染色的组织病理学检查、直接免疫荧光试验。