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Immune reconstitution inflammatory syndrome

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https://www.readbyqxmd.com/read/28475709/matrix-degradation-in-human-immunodeficiency-virus-type-1-associated-tuberculosis-and-tuberculosis-immune-reconstitution-inflammatory-syndrome-a-prospective-observational-study
#1
Naomi F Walker, Katalin A Wilkinson, Graeme Meintjes, Liku B Tezera, Rene Goliath, Janique M Peyper, Rebecca Tadokera, Charles Opondo, Anna K Coussens, Robert J Wilkinson, Jon S Friedland, Paul T Elkington
Background.: Extensive immunopathology occurs in human immunodeficiency virus (HIV)/tuberculosis (TB) coinfection, but the underlying molecular mechanisms are not well-defined. Excessive matrix metalloproteinase (MMP) activity is emerging as a key process but has not been systematically studied in HIV-associated TB. Methods.: We performed a cross-sectional study of matrix turnover in HIV type 1 (HIV-1)-infected and -uninfected TB patients and controls, and a prospective cohort study of HIV-1-infected TB patients at risk of TB immune reconstitution inflammatory syndrome (TB-IRIS), in Cape Town, South Africa...
May 5, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28470016/relationship-of-human-immunodeficiency-virus-viral-load-in-cerebrospinal-fluid-and-plasma-in-patients-co-infected-with-cryptococcal-meningitis
#2
Christina C Chang, Richard Kangethe, Saleha Omarjee, Keshni Hiramen, Bernadett Gosnell, Katlego Sojane, Mohamed-Yunus S Moosa, Sharon R Lewin, Martyn A French, Thumbi Ndung'u
We measured human immunodeficiency virus (HIV) ribonucleic acid (RNA) in paired cerebrospinal fluid (CSF) and plasma samples in a prospective study of 91 HIV-infected, antiretroviral therapy-naive patients with cryptococcal meningitis. Cerebrospinal fluid HIV RNA was lower than in plasma (median 4.7 vs 5.2 log10 copies/mL, P < .0001) and positively correlated with plasma HIV RNA, peripheral CD4(+) T-cell percentage, and CSF CXCL10. Plasma/CSF ratio of HIV RNA ranged widely from 0.2 to 265.5 with a median of 2...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28469696/hospital-days-attributable-to-immune-reconstitution-inflammatory-syndrome-in-persons-living-with-hiv-before-and-after-the-2012-dhhs-hiv-guidelines
#3
Peter Liu, Rebecca Dillingham, Kathleen McManus
BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) can manifest with initiation or reintroduction of antiretroviral therapy (ART) in persons living with HIV (PLWH). In 2012, updated United States treatment guidelines recommended initiation of ART for all PLWH regardless of CD4 count. The objectives of this study were to quantify hospital usage attributable to IRIS and assess the reasons for hospitalization in PLWH before and after the guideline update. METHODS: Subjects were PLWH between 18-89 years of age who were hospitalized between November 1, 2009 and July 31, 2014...
2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28464903/hospital-days-attributable-to-immune-reconstitution-inflammatory-syndrome-in-persons-living-with-hiv-before-and-after-the-2012-dhhs-hiv-guidelines
#4
Peter Liu, Rebecca Dillingham, Kathleen McManus
BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) can manifest with initiation or reintroduction of antiretroviral therapy (ART) in persons living with HIV (PLWH). In 2012, updated United States treatment guidelines recommended initiation of ART for all PLWH regardless of CD4 count. The objectives of this study were to quantify hospital usage attributable to IRIS and assess the reasons for hospitalization in PLWH before and after the guideline update. METHODS: Subjects were PLWH between 18-89 years of age who were hospitalized between November 1, 2009 and July 31, 2014...
May 2, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/28438129/severe-type-1-upgrading-leprosy-reaction-in-a-renal-transplant-recipient-a-paradoxical-manifestation-associated-with-deficiency-of-antigen-specific-regulatory-t-cells
#5
Ana Paula Vieira, Maria Angela Bianconcini Trindade, Flávio Jota de Paula, Neusa Yurico Sakai-Valente, Alberto José da Silva Duarte, Francine Brambate Carvalhinho Lemos, Gil Benard
BACKGROUND: Due to its chronic subclinical course and large spectrum of manifestations, leprosy often represents a diagnostic challenge. Even with proper anti-mycobacteria treatment, leprosy follow up remains challenging: almost half of leprosy patients may develop reaction episodes. Leprosy is an infrequent complication of solid organ transplant recipients. This case report illustrates the challenges in diagnosing and managing leprosy and its reactional states in a transplant recipient...
April 24, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28399724/the-epidemiology-of-iris-in-southern-india-an-observational-cohort-study
#6
Nisha Thambuchetty, Kayur Mehta, Karthika Arumugam, Umadevi G Shekarappa, Jyothi Idiculla, Anita Shet
Immune reconstitution inflammatory syndrome (IRIS) is an uncommon but dynamic phenomenon seen among patients initiating antiretroviral therapy (ART). We aimed to describe incidence, risk factors, clinical spectrum, and outcomes among ART-naive patients experiencing IRIS in southern India. Among 599 eligible patients monitored prospectively between 2012 and 2014, there were 59.3% males, with mean age 36.6 ± 7.8 years. Immune reconstitution inflammatory syndrome incidence rate was 51.3 per 100 person-years (95% confidence interval: 44...
January 1, 2017: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/28393665/the-first-report-of-bartonella-quintana-immune-reconstitution-inflammatory-syndrome-complicated-by-jarisch-herxheimer-reaction
#7
Michelle DallaPiazza, Matthew Jiro Akiyama
Bacillary angiomatosis (BA) is a rare complication of human immune deficiency virus (HIV) infection in the post-antiretroviral therapy (ART) era, and few cases of BA-associated immune reconstitution inflammatory syndrome (IRIS) have been described. We report the case of a 50-year-old man who presented with mass lesions involving the skin, subcutaneous tissues, muscle, and bone. The diagnosis of Bartonella quintana BA was confirmed by serum polymerase chain reaction. The patient's treatment course was complicated by both IRIS and Jarisch-Herxheimer reaction...
January 1, 2017: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/28375874/immune-reconstitution-inflammatory-syndrome-associated-with-toxoplasmic-encephalitis-in-hiv-infected-patients-a-multicenter-cohort-study
#8
Ward P H van Bilsen, Charlotte H S B van den Berg, Bart J A Rijnders, Kees Brinkman, Jan W Mulder, Luc B S Gelinck, Andy I M Hoepelman, Ferdinand W N M Wit, Diederik van de Beek, Jan M Prins
OBJECTIVES: To investigate the incidence and risk factors of immune reconstitution inflammatory syndrome (IRIS) associated with toxoplasmic encephalitis (TE) in patients starting cART. DESIGN: A historical multicenter cohort study. METHODS: We included all HIV-infected patients diagnosed with TE in six Dutch hospitals between 1996 and 2016. Diagnosis of TE-IRIS was made using predefined IRIS criteria. We distinguished paradoxical TE-IRIS (worsening of underlying treated infection) from unmasking TE-IRIS (unmasking of subclinical infection after start of cART)...
April 3, 2017: AIDS
https://www.readbyqxmd.com/read/28372806/multiple-immune-disorders-after-natalizumab-discontinuation-after-the-ciris-the-siris
#9
E K Van Obberghen, M Cohen, F Rocher, C Lebrun-Frenay
Natalizumab (NTZ) is an effective treatment for patients with highly active relapsing remitting multiple sclerosis (MS). However, when the therapy must be interrupted, it is important to anticipate the withdrawal to avoid reactivation or disease rebound. Described here is the case of a 35-year-old woman, with a past history of beta thalassemia, bulimia and asthma, who was diagnosed with MS at age 26. She was treated initially with first-line subcutaneous (sc) immunomodulatory treatments. However, due to liver toxicity, interferon beta-1a sc was interrupted and replaced by glatiramer acetate treatment, which was well tolerated and used for several years...
March 31, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28367350/immune-reconstitution-inflammatory-syndrome-occurring-in-a-kidney-transplant-patient-with-extrapulmonary-tuberculosis
#10
Jose Iglesias, Kandria Jumil Ledesma, Paul J Couto, Jessie Liu
Tuberculosis (TB) occurring in solid organ transplantation (SOT) is associated with significant morbidity and mortality usually due to delays in diagnosis, drug toxicity encountered with antimycobacterial therapy, and drug-drug interactions. TB in SOT patients may mimic other infectious and noninfectious posttransplant complications such as posttransplant lymphoproliferative disorder (PTLD) and systemic cytomegalovirus infection. Immune reconstitution inflammatory syndrome (IRIS) is a host response resulting in paradoxical worsening of an infectious disease which occurs after the employment of effective therapy and reversal of an immunosuppressed state...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28362522/multiple-sclerosis-update-use-of-mri-for-early-diagnosis-disease-monitoring-and-assessment-of-treatment-related-complications
#11
Mark S Igra, David Paling, Mike P Wattjes, Daniel J A Connolly, Nigel Hoggard
MRI has long been established as the most sensitive in vivo technique for detecting multiple sclerosis (MS) lesions. The 2010 revisions of the McDonald Criteria have simplified imaging criteria, such that a diagnosis of MS can be made on a single contrast-enhanced MRI scan in the appropriate clinical context. New disease-modifying therapies have proven effective in reducing relapse rate and severity. Several of these therapies, most particularly natalizumab, but also dimethyl fumarate and fingolimod, have been associated with progressive multifocal leukoencephalopathy (PML)...
April 26, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28349491/low-incidence-of-the-immune-reconstitution-inflammatory-syndrome-among-hiv-infected-patients-starting-antiretroviral-therapy-in-gabon-a-prospective-cohort-study
#12
S Janssen, K Osbak, R Holman, S Hermans, A Moekotte, M Knap, E Rossatanga, M Massinga-Loembe, A Alabi, A Adegnika, C Meenken, M van Vugt, P G Kremsner, G Meintjes, T van der Poll, M P Grobusch
There is a paucity of data on the immune reconstitution inflammatory syndrome (IRIS) in the Central African region. We followed ART-naive HIV-infected patients initiating antiretroviral therapy in an HIV clinic in Gabon, for 6 months. Among 101 patients, IRIS was diagnosed in five. All IRIS cases were mucocutaneous manifestations. There were no cases of tuberculosis (TB) IRIS, but active TB (n = 20) was associated with developing other forms of IRIS (p = 0.02). Six patients died. The incidence of IRIS is low in Gabon, with mild, mucocutaneous manifestations...
March 27, 2017: Infection
https://www.readbyqxmd.com/read/28348775/progressive-multifocal-leukoencephalopathy-and-black-fungus-in-a-patient-with-rheumatoid-arthritis-without-severe-lymphocytopenia
#13
Marieke J A de Regt, Jean-Luc Murk, Tilman Schneider-Hohendorf, Mike P Wattjes, Andy I M Hoepelman, Joop E Arends
INTRODUCTION: Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating brain infection caused by JC polyomavirus (JCV), primarily seen in patients with severely compromised cellular immunity. Clinical presentation varies depending on the affected white matter. PML prognosis is variable and effective treatments are lacking. CASE PRESENTATION: A 75-year-old Chinese woman with type 2 diabetes mellitus, chronic kidney disease and rheumatoid arthritis, treated with low-dose methotrexate and prednisolone for 2...
August 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28344059/gastrointestinal-toxicity-systemic-inflammation-and-liver-biochemistry-in-allogeneic-hematopoietic-stem-cell-transplantation
#14
Karina Jordan, Peter Pontoppidan, Hilde H Uhlving, Katrine Kielsen, Douglas G Burrin, Sarah Weischendorff, Ib J Christensen, Marianne H Jørgensen, Carsten Heilmann, Henrik Sengeløv, Klaus Müller
Liver toxicity is frequently seen in relation to allogeneic hematopoietic stem cell transplantation (HSCT), but pathogenesis and the risk factors are poorly understood. The purpose of this study was to investigate associations between liver toxicity, gastrointestinal toxicity, and levels of immune-regulating cytokines during the early post-transplantation period. We prospectively included 81 children and adults undergoing HSCT after myeloablative conditioning. Alanine aminotransferase (ALT), total bilirubin levels, and international normalized ratio were measured longitudinally until 3 months after the transplantation and related to levels of inflammatory markers (C-reactive protein [CRP], IL-6, and IL-10) and to plasma citrulline as a marker of intestinal toxicity during the first 3 weeks after HSCT...
March 23, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28333858/immune-reconstitution-inflammatory-syndrome-causing-progressive-optic-nerve-edema-in-cryptococcal-meningitis
#15
Astrid C Werner, Laurel N Vuong, Thomas R Hedges, Caroline R Baumal
PURPOSE: To report an human immunodeficiency virus-positive patient undergoing therapy for cryptococcal meningitis who developed progressive optic disc edema that was steroid responsive. METHODS: Observational case report. RESULTS: One month after commencing antifungal treatment for cryptococcal meningitis, the patient developed bilateral, progressive, recurrent optic disc edema with subretinal fluid that coincided with initiation of highly active antiretroviral therapy and recovery of CD4 cell counts...
March 22, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28322482/progressive-multifocal-leukoencephalopathy-associated-with-fumaric-acid-esters-treatment-in-psoriasis-patients
#16
Deepak M W Balak, Enes Hajdarbegovic, Wichor M Bramer, Martino H A Neumann, H Bing Thio
BACKGROUND: Fumaric acid esters (FAEs) are a systemic treatment for psoriasis considered to have a favorable long-term safety profile without an increased risk for immunosuppression. However, progressive multifocal leukoencephalopathy (PML), a rare, opportunistic viral infection of the central nervous system, has been linked anecdotally to FAE treatment. OBJECTIVE: to assess clinical features and outcomes of FAE-associated PML cases. METHODS: Systematic literature search in multiple databases up to February, 25(th) 2016 for reports of PML in psoriasis patients treated with FAEs...
March 21, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28321034/galectin-9-as-a-predictive-marker-for-the-onset-of-immune-related-adverse-effects-associated-with-anti-ccr4-moab-therapy-in-patients-with-adult-t-cell-leukemia
#17
Tareg Omer Mohammed, Haorile Chagan-Yasutan, Yugo Ashino, Wakana Nakayama, Yayoi Takahashi, Taizo Shimomura, Tetsuhiro Fujimoto, Yuko Watanabe, Toshiro Niki, Hitoshi Suzushima, Toshio Hattori
Adult T-cell leukemia/lymphoma (ATL/ATLL) is one of the most malignant lymphomas with poor prognosis. ATL/ATLL cells express CC chemokine receptor 4, and mogamulizumab (anti-CCR4 monoclonal antibody) exhibits strong cytotoxicity for ATL/ATLL cells. We analyzed plasma samples of 6 patients with ATL/ATLL treated with chemotherapy followed by mogamulizumab therapy (mogatherapy) for changes in the levels of biomarkers in relation to immune-related adverse effects. As treatment is often associated with skin eruptions, we investigated the profiles of inflammatory cytokines, including galectin-9 (Gal-9), which becomes increased in various infectious diseases and allergic patients...
March 2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28316373/nuclear-factor-of-activated-t-cells-and-cytokines-gene-expression-of-the-t-cells-in-aids-patients-with-immune-reconstitution-inflammatory-syndrome-during-highly-active-antiretroviral-therapy
#18
Jia Sun, Heling Chen, Yirui Xie, Junwei Su, Ying Huang, Lijun Xu, Michael Yin, Qihui Zhou, Biao Zhu
Background. The etiology of immune reconstitution inflammatory syndrome (IRIS) in AIDS patients after the initiation of HAART remains unknown. Several researches indicated that the development of IRIS is associated with the production and variation of cytokines, whose gene expression are closely related to the Ca2(+)/CN-nuclear factor of activated T cells (NFAT) pathway. Methods. We studied the expression of NFAT isoforms and their major target cytokines genes in peripheral blood CD3(+) T cells of subjects through fluorescence quantitative PCR and explored the expression changes of these genes before and after HAART...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28303782/paradoxical-reactions-and-the-immune-reconstitution-inflammatory-syndrome
#19
L W Preston Church, Amit Chopra, Marc A Judson
In HIV-infected individuals, paradoxical reactions after the initiation of antiretroviral therapy (ART) are associated with a variety of underlying infections and have been called the immune reconstitution inflammatory syndrome (IRIS). In cases of IRIS associated with tuberculosis (TB), two distinct patterns of disease are recognized: (i) the progression of subclinical TB to clinical disease after the initiation of ART, referred to as unmasking, and (ii) the progression or appearance of new clinical and/or radiographic disease in patients with previously recognized TB after the initiation of ART, the classic or "paradoxical" TB-IRIS...
March 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28275598/bilateral-ocular-myositis-associated-with-whipple-s-disease
#20
Vivak Parkash, Hardeep Singh Mudhar, Bart E Wagner, Didier Raoult, Ruth Batty, Hubert Lepidi, John Burke, Paul Collini, Thushan de Silva
PURPOSE: To describe the clinical features of a Caucasian female patient with a history of treated gastrointestinal Whipple's disease (WD) who developed new-onset diplopia, with a description of the histopathological features of the extraocular muscle biopsies. METHODS: A previously fit 38-year-old Caucasian female presented with acute-onset diplopia after being on a sustained medication regime for biopsy-proven gastrointestinal WD. A magnetic resonance imaging scan of her orbits with gadolinium revealed diffuse enhancement of the bellies of the extraocular muscles bilaterally, particularly the medial rectus, superior rectus, and superior oblique muscles, consistent with an infiltrative myositis...
January 2017: Ocular Oncology and Pathology
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