Hyperamylasemia and facial swelling in an HIV-infected man. Clearinghouse, P.O. Box 6003, Rockville, MD 20849-6003. 800-458-5231 ext. 5023. NLM AIDSLINE Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.

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Hyperamylasemia and facial swelling in an HIV-infected man. Clearinghouse, P.O. Box 6003, Rockville, MD 20849-6003. 800-458-5231 ext. 5023.

AIDS Clin Care. 1995 Jan;7(1):7, 9. Unique Identifier : AIDSLINE AIDS/95700013
Zuger A

Abstract: A 35-year old HIV-infected man who has been on AZT and TMP-SMX for five years with CD4 cell counts fluctuating between 150/mm3 and 200/mm3 for the last three years is presented in this case history. Because of elevated serum amylase, he was advised not to add ddI or ddC and decided to discontinue AZT, taking only TMP-SMX for the last six weeks. He begins not to feel well and complains of weight loss, night sweats and a funny feeling in his left ear and swelling of his face. Upon examination his face is asymmetric with a pronounced firm, nontender fullness at the angle of his left mandible and a suggestion for similar swelling on the right. He has large (2 to 3 cm), firm, nontender posterior cervical nodes bilaterally, as well as bilateral 4 cm axillary and inguinal nodes. Routine blood chemistries are normal with the exception of the elevated amylase, and a chest X-ray shows increased interstitial markings. It is possible that the patient is on the way to developing Diffuse Infiltrative Lymphocytosis Syndrome (DILS), characterized by the presence of abnormally high numbers of circulating CD8 T cells that infiltrate salivary glands, lungs, and other organs. An elevated serum amylase accompanied by a normal serum lipase also suggests hyperamylasemia of salivary gland origin. Follow-up indicated that the patients' lipase was normal and biopsy of parotid glands was negative for malignancy. It was determined that ddI would not be a retroviral of choice in patients with elevated amylase; a combination of AZT and ddC would be a more prudent choice.
Keywords: Adult Amylases/*BLOOD Diagnosis, Differential *Edema *Face Human HIV Infections/*COMPLICATIONS/ENZYMOLOGY Lymphocytosis/ETIOLOGY Male Parotid Gland/ABNORMALITIES NEWSLETTER ARTICLE REVIEWKWDadultamylases/KWDblooddiagnosis,differentialKWDedemaKWDfacehumanhivinfections/KWDcomplications/enzymologylymphocytosis/etiologymaleparotidgland/abnormalitiesnewsletterarticlereview
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