Immune reconstitution inflammatory syndrome in an HIV-infected patient with disseminated coccidioidomycosis

2019 ◽  
Vol 30 (9) ◽  
pp. 923-926 ◽  
Author(s):  
Andrew Y Lin ◽  
Victor Chun ◽  
Anish Dhamija ◽  
Talya Bordin-Wosk ◽  
Ankita Kadakia
Keyword(s):  
Antiretroviral Therapy ◽  
Mortality Rate ◽  
Inflammatory Response ◽  
Steroid Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Infected Patient ◽  
Immune Reconstitution ◽  
Immune Recovery ◽  
Inflammatory Syndrome ◽  
Excessive Inflammatory Response

Immune reconstitution inflammatory syndrome (IRIS) is a condition characterized by excessive inflammatory response to an underlying pathogen following immune recovery. IRIS associated with coccidioidomycosis infection is rare, with only a few cases reported to date. Unfortunately, the mortality rate for disseminated coccidioidomycosis-related IRIS in the available literature is extremely high. We present a case of paradoxical IRIS associated with disseminated coccidioidomycosis in an HIV-infected patient following initiation of antiretroviral therapy, who was successfully treated with steroid therapy.

scholarly journals Progressive multifocal leucoencephalopathy as a manifestation of immune reconstitution inflammatory syndrome in a patient with HIV infection: a case report

2020 ◽  
Vol 7 (7) ◽  
pp. 1187
Author(s):  
Nitish J. Sawan ◽  
Anita Basavaraj
Keyword(s):  
Case Report ◽  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Infected Patient ◽  
Immune Reconstitution ◽  
Jc Virus ◽  
Interesting Case ◽  
Progressive Multifocal Leucoencephalopathy ◽  
Paradoxical Worsening ◽  
Inflammatory Syndrome

Immune reconstitution inflammatory syndrome (IRIS) is defined as paradoxical worsening of a known condition or the appearance of a new condition after initiating antiretroviral therapy (ART) in HIV-infected patients. IRIS results from restored immunity to specific infectious or non-infectious antigens. Immune reconstitution following initiation of ART may lead to activation of an inflammatory response to detectable or latent JC virus (JCV) infection, an etiological agent of progressive multifocal leucoencephalopathy (PML). We present an interesting case of IRIS manifesting as PML in a newlydiagnosed HIV-infected patient started on ART.

Hypercalcaemia complicating immune reconstitution in an HIV-infected patient with disseminated tuberculosis

2006 ◽  
Vol 17 (5) ◽  
pp. 349-350 ◽  
Author(s):  
R A Ferrand ◽  
A Elgalib ◽  
W Newsholme ◽  
A Childerhouse ◽  
S G Edwards ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Infected Patient ◽  
Immune Reconstitution ◽  
Hiv Positive ◽  
Disseminated Tuberculosis ◽  
Highly Active ◽  
Inflammatory Syndrome

An HIV positive man being treated for disseminated tuberculosis developed hypercalcaemia 17 days after starting highly active antiretroviral therapy (HAART). Hypercalcaemia resolved with stopping HAART and was thought to be due to immune reconstitution inflammatory syndrome.

Immune Reconstitution Inflammatory Syndrome

2011 ◽  
Vol 23 (1) ◽  
pp. 90-96 ◽  
Author(s):  
A.R. Tappuni
Keyword(s):  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
T Regulatory Cells ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Clinical Intervention ◽  
Suppressor Cell ◽  
Life Threatening ◽  
Inflammatory Syndrome

Immune reconstitution inflammatory syndrome (IRIS) is a phenomenon observed in patients recovering from immunodeficiency. The clinical presentation of IRIS involves the unmasking of covert infections or the worsening of overt conditions. Several causes and pathways have been suggested, most recognizing an inflammatory flare component occurring in the context of rapid immune reconstitution. In HIV-infected patients, IRIS inadvertently occurs as the consequence of successful antiretroviral therapy, and it is affiliated with improvement of the immune function, complicating the course of the disease and presenting treatment challenges to clinicians. The pathogenesis of IRIS is poorly understood, but in recovering HIV patients, its initiation and progression seem to be primarily linked to an increase in CD4+ T-helper and CD8+ T-suppressor cell count and a reduction in T-regulatory cells, all endorsed by exaggerated cytokine release and activity. The clinical presentation of IRIS is usually atypical. The manifestations depend on the trigger antigen, which can be an infective agent (viable or nonviable), a host antigen, or a tumor antigen. Most IRIS cases are self-limiting, but a few cases can be overwhelming and life-threatening; hence, early recognition is important. In most cases, there is no need to discontinue the antiretroviral therapy, although in the more severe cases, other clinical intervention may be necessary.

scholarly journals Acute gouty arthritis as a manifestation of immune reconstitution inflammatory syndrome after initiation of antiretroviral therapy

2012 ◽  
Vol 54 (4) ◽  
pp. 231-233 ◽  
Author(s):  
Walter de Araujo Eyer-Silva ◽  
Maria Cecília da Fonseca Salgado ◽  
Jorge Francisco da Cunha Pinto ◽  
Fernando Raphael de Almeida Ferry ◽  
Rogério Neves-Motta ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Gouty Arthritis ◽  
Infected Male ◽  
Acute Gouty Arthritis ◽  
Highly Active ◽  
History Of ◽  
Inflammatory Syndrome

Immune reconstitution inflammatory syndrome (IRIS) in HIV-infected subjects initiating antiretroviral therapy most commonly involves new or worsening manifestations of previously subclinical or overt infectious diseases. Reports of non-infectious IRIS are much less common but represent important diagnostic and treatment challenges. We report on a 34-year-old HIV-infected male patient with no history of gout who developed acute gouty arthritis in a single joint one month after initiating highly active antiretroviral therapy.

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