Interstitial lung disease and xerostomia as initial manifestations in a patient with human immunodeficiency virus infection

Seng-Eng Ooi, Chang-Youh Tsai, Chung-Tei Chou
Division of Allergy, Immunology and Rheumatology, Department of Medicine, Taipei Veterans General Hospital; and National Yang-Ming University School of Medicine, Taipei, Taiwan

Received: January 5, 2004 Revised: January 12, 2004 Accepted: June 18, 2004

Corresponding author: Chang-Youh Tsai, M.D.,Ph.D., Division of Allergy, Immunology and Rheumatology, Department of Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Road, Section 2, Taipei 112, Taiwan. E-mail:

A 56-year-old human immunodeficiency virus (HIV)-infected man presented with progressive interstitial lung disease (ILD) and lymphocyte infiltration of the salivary glands which mimicked autoimmune disease. Pneumonia, which was very likely caused by Pneumocystis carinii, developed after 3 courses of monthly methylprednisolone pulse therapy for ILD. Both enzyme immunoassay and Western blot analysis confirmed the HIV infection. After antibiotic treatment, the pneumonia gradually resolved. Autoimmune manifestations such as ILD and xerostomia may be initial presentations of HIV infection. Immunosuppressive drugs must be used cautiously in these patients. Screening for HIV is mandatory in the differential diagnosis of patients with ILD or xerostomia.

Key words: HIV, interstitial lung disease, lymphocytosis, xerostomia

J Microbiol Immunol Infect2005;38:145-148.