C. Chiriac 1, Prof. dr. R. Pascu 1, I. Kezdi 1, A. Balint 3, M. Dobreanu 2, A. Incze 1, D. Părvu 4, V. Căreianu 5
1 UMF Tg Mureş – Clinica Boli Infecţioase
2 UMF Tg Mureş – Laboratorul de Biologie Moleculară
3 Clinica Ortopedie II, Spitalul Clinic Judeţean de Urgenţă Tg. Mureş
4 Laborator Boli Infecţioase, Spitalul Clinic Judeţean de Urgenţă Tg. Mureş
5 Clinica de Radiologie şi Imagistică Medicală, Spitalul Clinic Judeţean de Urgenţă Tg. Mureş
Abstract
The syndrome of lipodistrophy associated with osteonecrosis in an adolescent infected with HIV introduction: HAART significantly increased the lifespan of a patients infected with HIV and at the same time it generated new pathologies of increased complexity and not completely elucidated: mitochondrial pathology, disorders of the glucido-lipid metabolism, lipodystrophy syndrome, osteopenia/osteonecrosis. Objective: it is presented the case of an HIV seropositive patient with lipodystrophy syndrome and osteonecrosis of the femur. Material and method: a complex analysis of demographic and clinical characteristics of risk factors associated with the HAART therapy, which generated the lipodystrophy syndrome and osteopenia, correspondingly the osteonecrosis of the femur in a female adolescent infected with HIV Results: M.A., a 17 year old patient diagnosed with AIDS presents a complex associated pathology: frontal right operated tumor, meningoencephalitis with Cryptococcus neoformans, syndrome of intermittent intracranial hypertension, symptomatic epilepsy, pulmonary tuberculosis. The mean value of TCD4 lymphocytes is 332/mm3. The exposition time to nucleoside reverse transcriptase inhibitors (NRTI) and protease inhibitors (PI) is of 60 months. Starting from December 2006 the patient complained of aches and pains and functional impotence at the articulation level of the humerus and right hip. As a result of seriate bone radiography, osteodensitometry (DEXA) and orthopedic examination the diagnosis of osteopenia, 1st stage aseptic necrosis of the right femur (ANF) was set up. The associated risk factors were: hyperlipidemia (the mean value of triglycerides was 196mg/dl and the total value of cholesterolemy: 229mg/dl) and exposition to corticotherapy for an average of 2 months. Conclusions: Osteonecrosis correlated with HIV infection appears as an emergent complication with an increasing incidence associated with specific risk factors like hyperlipidemy associated with antiretroviral therapy and exposition to corticosteroids.