Kaposi's sarcoma after long-acting steroids: time until remission and drug washout

Dermatology : International Journal for Clinical and Investigative Dermatology
D NassarCeleste Lebbe

Abstract

Long-acting steroids (LAS) are widely used to treat various inflammatory diseases and allergies. They have many adverse effects including the inhibition of the hypothalamopituitary axis that can last several months. LAS are also strong immunosuppressors and can result in severe opportunistic infections and immunodeficiency-related malignancies. However, the time needed for immune recovery after withdrawal of LAS is unknown. Here we report a case of Kaposi's sarcoma (KS) and severe immunosuppression after a chronic triamcinolone acetonide (TA) treatment. Six months after withdrawal, traces of TA were still detected in the serum by HPLC mass spectrometry. At 8 months, the drug became undetectable, and clinical and biological signs of immune recovery - beginning of KS regression, normalization of IgG levels and CD4 T lymphocyte counts - became noticeable. We then provide a review of the literature on the time until remission of KS after immunosuppression reduction. We also reviewed the cases of KS induced by TA, and the metabolic side effects of TA when compared to standard glucocorticoids.

Citations

Jul 4, 2012·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·S KrengelR Gutzmer
Jun 15, 2012·Journal of the American Academy of Dermatology·Elodie Régnier-RosencherNicolas Dupin
Aug 20, 2015·International Journal of Clinical Pharmacy·Soyeon YooGwanpyo Koh
Dec 21, 2010·The British Journal of Dermatology·K-M ThomsL Kretschmer
May 10, 2011·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Leo JengMary D Ruppe
Dec 24, 2015·The British Journal of Dermatology·A Mayor-IbargurenB Lecumberri

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