A Challenging Case of Kaposi Sarcoma Inflammatory Cytokine Syndrome

Kaposi Sarcoma Inflammatory Cytokine Syndrome (KICS) is a serious, uncommon disease that occurs in patients who are positive for HIV and human herpesvirus-8 (HHV-8). It characterized by constellation of clinical findings, including fever, weight loss, fluid retention, as well lack multicentric Castleman (MCD) features on histopathology an elevated serum HHV-8 viral load. Diagnosis often delayed, treatment options limited, culminating high mortality rates. We hereby present 32-year-old male patient with was untreated few years came night sweats, pancytopenia, widespread adenopathy. A thorough evaluation opportunistic infections unremarkable. Clinically MCD suspected, but lymph node biopsy only showed sarcoma (KS) no characteristic MCD. However, deterioration, KICS strongly suspected. immune reconstitution syndrome (KS-IRIS) also possibility the restarted antiretroviral therapy. Rituximab commenced, suffered cardiac arrest could not be revived. Alternative diagnosis must explored presenting constitutional symptoms, cytopenia, adenopathy after malignancies ruled out. If they have KS positivity there biopsy, prompt suspicion should made, rituximab and/or chemotherapy instituted rapidly. KS-IRIS possible if recently received therapy rapid decline load increase CD4 counts (immunological recovery). HHV8 levels may help to distinguish between these two inflammatory conditions.