# A Case Report of Atypical Oral Angiolymphoid Hyperplasia With Eosinophilia (ALHE) Presenting as an Immune Reconstitution Inflammatory Syndrome in a Patient With HIV

## TL;DR

A man with HIV developed a rare throat lesion after restarting treatment, likely due to immune system overreaction.

## Contribution

This case highlights ALHE as a potential immune reconstitution inflammatory syndrome in HIV patients.

## Key findings

- The lesion's growth correlated with rising CD4+ T-cell counts during ART.
- ALHE diagnosis was complicated by atypical immune responses in HIV patients.
- The case suggests immune reconstitution can trigger inflammatory syndromes like ALHE.

## Abstract

A 35‐year‐old man with uncontrolled human immunodeficiency virus (HIV) infection presented with a pharyngeal plaque‐like lesion after recommencing antiretroviral treatment (ART). Rapid localized growth of the lesion paralleled his rising CD4+ T‐cell count, suggesting immune reconstitution–mediated deterioration. The diagnosis of the lesion as angiolymphoid hyperplasia with eosinophilia was made more challenging by the atypical immune response that accompanies the HIV‐associated immune reconstitution inflammatory syndrome.