RESUMO
Immune reconstitution syndrome (IRIS) is an uncommon complication seen in patients living with human immunodeficiency virus (HIV) characterized by the decline in a pre-existing condition or a new diagnosis of a masked disease. It is associated with a significant inflammatory component that occurs after starting antiretrovirals, being most frequent in those with severe immunosuppression. Thereby, different types of opportunistic diseases such as non-tuberculous mycobacteria are more frequent in this group of patients, especially those with low lymphocyte counts of below 50 cells/µL. Here, we present the case of an HIV-positive patient who developed lymphadenitis caused by Mycobacterium intracellulare as an unmasked IRIS after initiating treatment for HIV.
RESUMO
Blastic plasmacytoid dendritic cell neoplasm is a rare hematologic neoplasm characterized by cutaneous, hematologic, and central nervous system (CNS) involvement with poor prognosis. Diagnosis is made by flow cytometry, although there are no specific markers, making its diagnosis challenging. So far, with the available evidence, acute lymphoid leukemia-type schemes and consolidation with allogeneic transplant seem to become the first-line therapy. With its characterization, new therapies directed toward CD123 and the anti-apoptotic protein Bcl-2 have appeared to prolong the survival of these patients. We present a case of a 27-year-old male patient diagnosed with blastic plasmacytoid dendritic cell neoplasm with unusual CNS manifestations and without skin involvement who achieved complete remission with venetoclax and improvement of neurological symptoms, making him a candidate for hematopoietic stem cell transplant.