scholarly journals Frosted branch angiitis due to cytomegalovirus-associated unmasking immune reconstitution inflammatory syndrome: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shi Tang ◽  
Ning Zhao ◽  
Li Yang Wang ◽  
Ying Wen
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Case Presentation ◽  
Cmv Retinitis ◽  
Frosted Branch Angiitis ◽  
Immunodeficiency Virus ◽  
Common Opportunistic Infection ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Inflammatory Syndrome

Abstract Background Cytomegalovirus (CMV) retinitis is a common opportunistic infection in patients with acquired immunodeficiency syndrome. The common funduscopic manifestations are haemorrhagic necrotising variety and granular variety. Frosted branch angiitis (FBA), as a special form, when it occurred after antiretroviral therapy(ART), could possibly be associated with immune reconstitution. We report a case of FBA secondary to CMV infection-associated unmasking immune reconstitution inflammatory syndrome (IRIS). Case presentation A 27-year-old man with human immunodeficiency virus infection developed FBA after 35 days of ART. The left Aqueous humour (AqH) tested positive for CMV DNA, and the patient was diagnosed with CMV retinitis. The degree of intraocular inflammation was reflected by increased levels of interleukin (IL)-6 and IL-8 in AqH. After anti-CMV treatment and continuous ART for several months, his FBA and vision significantly improved. CMV DNA became undetectable in the left AqH, and the IL-6 and IL-8 levels in AqH decreased. Conclusion FBA could be a sign of CMV-associated unmasking IRIS. Anti-CMV treatment alone or combination with steroid treatment may be administered, depending on the changes in CMV DNA load and immunologic profile of AqH.

scholarly journals The Presentation of Multiple Perforations in the Small Bowel as Cytomegalovirus Related Immune Reconstitution Inflammatory Syndrome in an HIV-infected Patient: a Case Report

2021 ◽  
Author(s):  
Wang Yanli ◽  
Xuyong Lin ◽  
Yuji Li ◽  
Ying Wen
Keyword(s):  
Small Bowel ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Infected Patient ◽  
Immune Reconstitution ◽  
Opportunistic Infections ◽  
Exploratory Laparotomy ◽  
Pathological Examination ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

Abstract Background: Multiple perforations in the small bowel as cytomegalovirus (CMV) related immune reconstitution inflammatory syndrome (IRIS) in an human immunodeficiency virus (HIV)-infected patient is very rare. Up to now, only five IRIS-associated cases including our case were reported. We performed pathological examination, metagenomic next-generation sequencing (mNGS), CMV and immune cells immunohistochemical staining for rapid diagnosis and differential diagnosis.Case presentation: We describe a case with multiple perforations in the small bowel as CMV related IRIS in an HIV-infected patient. The patient appeared multiple perforations in the small bowel after 26 days of antiretroviral therapy (ART). The patient underwent exploratory laparotomy. Partial resection and surgical repair of small intestine were performed. CMV enteritis was confirmed by immunohistochemistry staining and other opportunistic infections were excluded by mNGS. However, he died from intestinal obstruction and septic shock at 55 days after surgery. Conclusions: Perforations due to CMV related IRIS are very rare, and usually lack the prodromal period symptoms of abdominal pain and diarrhea. It is not easily foreseen and appears shortly after ART. The condition of intestinal perforations is lethal, and early identification and surgical treatment are lifesaving.

scholarly journals Association Between Plasma Antibody Responses and Risk for Cryptococcus-Associated Immune Reconstitution Inflammatory Syndrome

2018 ◽  
Vol 219 (3) ◽  
pp. 420-428 ◽  
Author(s):  
Hyun Ah Yoon ◽  
Antonio Nakouzi ◽  
Christina C Chang ◽  
Mark H Kuniholm ◽  
Leandro J Carreño ◽  
...  
Keyword(s):  
B Cells ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Memory B Cells ◽  
Hiv Viral Load ◽  
Immunodeficiency Virus ◽  
Plasma Antibody ◽  
Inflammatory Syndrome ◽  
The Relationship ◽  
Cd4 T Cell Count

AbstractBackgroundInitiation of antiretroviral therapy (ART) in human immunodeficiency virus (HIV)-infected individuals with cryptococcal meningitis places them at risk for Cryptococcus-associated immune reconstitution inflammatory syndrome (C-IRIS). The relationship between antibody immunity and C-IRIS risk has not been investigated.MethodsWe compared plasma levels of immunoglobulins, C. neoformans glucuronoxylomannan (GXM) capsule-specific and laminarin (Lam)-binding IgM and IgG, and percentages of peripheral blood total and memory B cells between 27 HIV-infected patients with CM who developed C-IRIS and 63 who did not, and evaluated associations of these parameters with risk of C-IRIS.ResultsPrior to initiation of ART, plasma IgM, Lam-binding IgM (Lam-IgM), Lam-IgG, and GXM-IgM levels were significantly lower in patients who developed C-IRIS than those who did not. Multivariate analysis revealed significant inverse associations between C-IRIS and IgM (P = .0003), Lam-IgM (P = .0005), Lam-IgG (P = .002), and GXM-IgM (P = .002) independent of age, sex, HIV viral load, CD4+ T-cell count, and cerebrospinal fluid fungal burden. There were no associations between C-IRIS and total or memory B cells.DiscussionAntibody profiles that include plasma IgM, Lam-IgM, Lam-IgG, and/or GXM-IgM may have value in furthering our understanding of C-IRIS pathogenesis and hold promise as candidate biomarkers of C-IRIS risk.

Immune reconstitution inflammatory syndrome associated with secondary syphilis: dermatologic, neurologic and ophthalmologic compromise in an HIV patient

2019 ◽  
Vol 30 (5) ◽  
pp. 509-511
Author(s):  
Sami Alcedo ◽  
Renee Newby ◽  
Juan José Montenegro ◽  
Paola Rondan ◽  
Jorge Arevalo ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Secondary Syphilis ◽  
Immune Reconstitution Syndrome ◽  
Clinical Expression ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

The presentation of syphilis as a manifestation of immune reconstitution inflammatory syndrome in patients with human immunodeficiency virus (HIV) infection is rare and can be associated with the varied clinical expression of unusual syphilitic manifestations. We report a case of immune reconstitution syndrome with dermatologic, ophthalmologic and neurologic compromise of secondary syphilis in a patient with HIV infection.

scholarly journals Declines in Lung Function After Antiretroviral Therapy Initiation in Adults With Human Immunodeficiency Virus and Tuberculosis: A Potential Manifestation of Respiratory Immune Reconstitution Inflammatory Syndrome

2019 ◽  
Vol 70 (8) ◽  
pp. 1750-1753 ◽  
Author(s):  
Sara C Auld ◽  
Pholo Maenetje ◽  
Shruthi Ravimohan ◽  
Drew Weissman ◽  
Itai Ncube ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Lung Function ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Research Attention ◽  
Therapy Initiation ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

Abstract End-organ impairment has received relatively little research attention as a possible manifestation of tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS). In this prospective cohort study, one-half of adults with human immunodeficiency virus and pulmonary tuberculosis experienced meaningful declines in lung function on antiretroviral therapy, suggesting a role for lung function in TB-IRIS definitions.

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