Orbital non-HIV immune reconstitution inflammatory syndrome after cytapheresis

2020 ◽  
pp. 112067212091933
Author(s):  
Jeremy Chiabo ◽  
Sacha Nahon-Esteve ◽  
Mohamed Alketbi ◽  
Sandra Lassalle ◽  
Nathalie Tieulie ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Highly Active ◽  
First Case ◽  
Neutropenic Patients ◽  
Mantel Cell Lymphoma ◽  
Intravenous Steroids ◽  
Inflammatory Syndrome ◽  
Work Up

The immune reconstitution inflammatory syndrome is a phenomenon typically described in HIV patient during the restoration of CD4 count after highly active antiretroviral therapy. Non-HIV immune reconstitution inflammatory syndrome has also been described after organ transplantation or immune recovery in neutropenic patients. We report the case of a 50-year-old man who presented to our department with left painful proptosis and ophthalmoplegia 2 days after having performed cytapheresis for a mantel cell lymphoma. Systemic work up and biopsy were performed and symptoms were relieved with intravenous steroids therapy. To our knowledge, this is the first case of orbital non-HIV immune reconstitution inflammatory syndrome described in the literature.

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.

scholarly journals Cryptococcal Lymphadenitis in an HIV-Infected Patient: A Rare Manifestation of Immune Reconstitution Inflammatory Syndrome

Diseases ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 70
Author(s):  
Jose Gonzales Zamora ◽  
Yogeeta Varadarajalu
Keyword(s):  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Granulomatous Inflammation ◽  
Highly Active ◽  
Rare Manifestation ◽  
Previously Treated ◽  
Immunodeficiency Syndrome ◽  
Inflammatory Syndrome

Cryptococcosis is a fungal infection that is typically associated with acquired immunodeficiency syndrome (AIDS). The advent of highly active antiretroviral therapy has decreased the frequency of this infection, but has led to the emergence of atypical cases of immune reconstitution inflammatory syndrome (IRIS). Here, we describe the case of a 40-year-old man who was diagnosed with HIV infection and cryptococcal meningitis. He was successfully treated with antifungals and then started antiretroviral therapy. The patient returned to the hospital 15 months later complaining of fever, pain, and neck swelling. A computed tomography (CT) scan revealed a conglomerate of necrotic lymph nodes in the supraclavicular region. He underwent biopsy and histology showed granulomatous inflammation with fungal elements, consistent with Cryptococcus. He tested positive for serum cryptococcal antigen. The patient was treated with liposomal amphotericin and flucytosine. After induction therapy, he was re-started on fluconazole. The final fungal cultures were negative. We attributed our patient’s clinical presentation to “paradoxical” IRIS, which was associated with his previously treated cryptococcosis. Near resolution of the supraclavicular mass was noted at the 3-month follow-up.

scholarly journals Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome Manifested As Multiple Central Nervous System Granulomas In Non-HIV Patient: A Case Report

2021 ◽  
Author(s):  
Can-Hong YANG ◽  
Qing-Gan Zeng ◽  
Tian-Ming Lü
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Tuberculosis Patient ◽  
Immunocompromised Patients ◽  
Highly Active ◽  
Mycobacteria Tuberculosis ◽  
Inflammatory Syndrome

Abstract Background: In addition to developed in HIV patient during highly active antiretroviral therapy, immune reconstitution inflammatory syndrome (IRIS) has also been well recognized in non-HIV immunocompromised patients induced by latent viruses, untreated microorganisms, or treating microorganisms. Mycobacteria tuberculosis is one of the most common pathogens inducing IRIS.Case presentation: Here, we report a tuberculosis patient progressed with IRIS that additional central nervous system (CNS) granuloma occurred during the anti-tuberculosis treatment (ATT) process with her pulmonary symptoms improved after quadruple anti-tuberculosis. This case highlights the need to increase the awareness of IRIS in non-HIV immunocompromised patients.Conclusions: TB-IRIS must be considered when the condition deteriorates or development of new lesions at distant sites in the course of ATT. Early identification and diagnosis help to handle timely and correctly.

scholarly journals Neuroimaging Features of Immune Reconstitution Inflammatory Syndrome in a Patient with AIDS Successfully Treated for Neurocryptococcosis

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Antônio O. F. da Silva ◽  
Luciano Z. Goldani
Keyword(s):  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Early Complication ◽  
Highly Active ◽  
Inflammatory Syndrome ◽  
Late Manifestation

The use of highly active antiretroviral therapy (HAART) has significantly reduced the incidence and progression of HIV-associated cryptococcosis. However, an early complication of HAART is the immune reconstitution inflammatory syndrome (IRIS), which may affect the CNS. The authors report a patient successfully treated for cryptococcosis and HIV who presented a late manifestation of IRIS. Neuroimaging aspects and management of CNS-IRIS in this patient are discussed in this paper.

Incidence and risk factors for immune reconstitution inflammatory syndrome during highly active antiretroviral therapy

AIDS ◽  
2005 ◽  
Vol 19 (4) ◽  
pp. 399-406 ◽  
Author(s):  
Samuel A Shelburne ◽  
Fehmida Visnegarwala ◽  
Jorge Darcourt ◽  
Edward A Graviss ◽  
Thomas P Giordano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Highly Active ◽  
Inflammatory Syndrome
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