Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2023; 11(17): 4202-4209
Published online Jun 16, 2023. doi: 10.12998/wjcc.v11.i17.4202
Crohn’s disease in human immunodeficiency virus-infected patient: A case report
Ausra Vinikaite, Benediktas Kurlinkus, Dominyka Jasinskaite, Sandra Strainiene, Audrone Buineviciute, Goda Sadauskaite, Vytautas Kiudelis, Edita Kazenaite
Ausra Vinikaite, Dominyka Jasinskaite, Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas 44307, Lithuania
Benediktas Kurlinkus, Audrone Buineviciute, Goda Sadauskaite, Edita Kazenaite, Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
Benediktas Kurlinkus, Audrone Buineviciute, Goda Sadauskaite, Edita Kazenaite, Center of Hepatology, Gastroenterology and Dietology, Vilnius University Hospital Santaros Clinics, Vilnius 08661, Lithuania
Sandra Strainiene, Department of Internal Medicine and Surgery, Antakalnis Clinic, Vilnius 10207, Lithuania
Vytautas Kiudelis, Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas 44307, Lithuania
Author contributions: Vinikaite A and Jasinskaite D searched the literature and wrote the article based on the data analyzed (provided by Kurlinkus B); Sadauskaite G and Buineviciute A were the gastroenterologists who followed up with the patient; Kurlinkus B obtained the patient’s informed consent and performed data extraction; Kurlinkus B, Kiudelis V, and Strainiene S reviewed and edited the manuscript; Sadauskaite G and Kazenaite E revised the manuscript for important intellectual content; and all authors have read and approved the final manuscript.
Informed consent statement: The authors declare that written informed consent was obtained from the patient for the publication of this report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sandra Strainiene, MD, Lecturer, Department of Internal Medicine and Surgery, Antakalnis Clinic, Antakalnis Str. 59, Vilnius 10207, Lithuania. sandra.strainiene@gmail.com
Received: April 22, 2023
Peer-review started: April 22, 2023
First decision: April 26, 2023
Revised: May 4, 2023
Accepted: May 12, 2023
Article in press: May 12, 2023
Published online: June 16, 2023
Processing time: 50 Days and 13.3 Hours
Abstract
BACKGROUND

Inflammatory bowel disease (IBD) is an autoimmune condition treated with immunosuppressive drugs. However, the need for immune system suppression becomes questionable when infection with the human immunodeficiency virus (HIV) occurs simultaneously and impacts the course of IBD. Our reported case represents the clinical course, prescribed treatment and its effect, as well as clinical challenges faced by physicians in a combination of such diseases. We also present a comprehensive literature review of similar cases.

CASE SUMMARY

A 49-year-old woman suffering from a newly diagnosed Crohn’s disease was hospitalized due to exacerbated symptoms (abdominal pain, fever, and weight loss). During her hospital stay, she tested positive for HIV. With conservative treatment, the patient improved and was discharged. In the outpatient clinic, her HIV infection was confirmed as stage C3, and antiretroviral treatment was initiated immediately. That notwithstanding, soon the patient was rehospitalized with pulmonary embolism and developed a series of complications because of the subsequent coexistence of IBD and HIV. After intensive and meticulous treatment, the patient’s condition has improved and she remains in remission.

CONCLUSION

The paucity of studies and data on the coexistence of HIV and IBD leaves clinicians doubting the optimal treatment options.

Keywords: Crohn’s disease; Inflammatory bowel disease; Human immunodeficiency virus; Immunocompromised patient; Case report

Core Tip: We present the case of a middle-aged female with Crohn’s disease and concomitant human immunodeficiency virus (HIV) infection to improve knowledge of the rare and understudied interrelation of these two conditions. The paucity of studies and data on HIV and inflammatory bowel disease coinfection leaves clinicians doubting the optimal treatment options. This report reminds experts of the importance of early diagnostics and discusses the specific treatment and prophylactic guidelines when both diseases are present to prevent a variety of complications.