Diffuse infiltrative lymphocytosis syndrome (DILS) is a benign disorder involving polyclonal CD8 lymphocytic infiltration of tissues, which has some features in common with Sjogren’s syndrome. It is linked to human leucocyte antigen (HLA)-DRB1. Most patients have a CD8 lymphocytosis. DILS usually presents in patients with mild immune suppression. The most common manifestation is bilateral parotid gland enlargement; the glands are often massive, with lymphoepithe[1]lial cysts on histology. Other salivary glands may also be enlarged. Sicca symptoms are common but usually mild. Lymphocytic interstitial pneumonitis is the most common manifestation outside the salivary glands. Generalised lymphadenopathy with nodes, larger than those seen with persistent generalised lym[1]phadenopathy of HIV, may occur. Hepatitis, mono[1]neuritis, polyarthritis and polymyositis may also occur.
The manifestations outside the salivary glands usually respond to steroids. The parotid glands are treated for cosmetic reasons but surgery is best avoided. Aspiration of parotid cysts and instillation of a sclerosant are of some benefit. Low-dose irradiation has also been used successfully. DILS may regress on ART but response is variable.
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