Sezary Syndrome during use of antiretroviral therapy

Abstract

Objective: To describe a case of Sézary Syndrome (SS) in a patient diagnosed with human immunodeficiency virus (HIV) infection and using antiretroviral therapy (ART). Case details: Female patient, 41 years old, with pruritic erythroderma for five months, associated with supraclavicular lymph node enlargement and facial infiltration. He had a history of HIV with an undetectable viral load after seven months of ART. Laboratory tests revealed an elevated CD4 cell count and immunophenotyping compatible with SS. The diagnosis was confirmed by histopathology and immunohistochemistry, with findings of clonal proliferation of CD4+ T lymphocytes and the presence of Sézary cells in peripheral blood. Treatment included UVB-narrow band phototherapy and systemic chemotherapy, with progressive clinical improvement. Final considerations: SS is a rare disease and, when associated with HIV, may present changes in its presentation and clinical evolution, which makes diagnosis difficult. The case presents a diagnosis of SS, confirmed by histopathology and immunophenotyping, during the use of ART, reporting significant clinical improvement of the patient after combined management with UVB-narrow band phototherapy and chemotherapy. However, it is highlighted that stem cell transplantation is the only curative option.