Immune Reconstitution Inflammatory Syndrome: Opening Pandora’s Box
Joint Authors
Souto de Moura, Conceição
França, Margarida
Meireles, Mariana
Source
Case Reports in Infectious Diseases
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-01-09
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
One of the purposes of antiretroviral therapy (ART) is to restore the immune system.
However, it can sometimes lead to an aberrant inflammatory response and paradoxical clinical worsening known as the immune reconstitution inflammatory syndrome (IRIS).
We describe a 23-year-old male, HIV1 infected with a rapid progression phenotype, who started ART with TCD4+ of 53 cells/mm3 (3,3%) and HIV RNA = 890000 copies/mL (6 log).
Four weeks later he was admitted to the intensive care unit with severe sepsis.
The diagnostic pathway identified progressive multifocal leukoencephalopathy, digestive Kaposi sarcoma, and P.
aeruginosa bacteraemia.
Five weeks after starting ART, TCD4+ cell count was 259 cells/mm3 (15%) and HIV RNA = 3500 copies/mL (4 log).
He developed respiratory failure and progressed to septic shock and death.
Those complications might justify the outcome but its autopsy opened Pandora’s box: cerebral and cardiac toxoplasmosis was identified, as well as hemophagocytic syndrome, systemic candidiasis, and Mycobacterium avium complex infection.
IRIS remains a concern and eventually a barrier to ART.
Male gender, young age, low TCD4 cell count, and high viral load are risk factors.
The high prevalence of subclinical opportunistic diseases highlights the need for new strategies to reduce IRIS incidence.
American Psychological Association (APA)
Meireles, Mariana& Souto de Moura, Conceição& França, Margarida. 2017. Immune Reconstitution Inflammatory Syndrome: Opening Pandora’s Box. Case Reports in Infectious Diseases،Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1146350
Modern Language Association (MLA)
Meireles, Mariana…[et al.]. Immune Reconstitution Inflammatory Syndrome: Opening Pandora’s Box. Case Reports in Infectious Diseases No. 2017 (2017), pp.1-4.
https://search.emarefa.net/detail/BIM-1146350
American Medical Association (AMA)
Meireles, Mariana& Souto de Moura, Conceição& França, Margarida. Immune Reconstitution Inflammatory Syndrome: Opening Pandora’s Box. Case Reports in Infectious Diseases. 2017. Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1146350
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1146350