Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS

Toxoplasma encephalitis immune reconstitution inflammatory syndrome (TE-IRIS) is rare and usually occurs in an unmasking, rather than paradoxical form. To the best of our knowledge, only two cases of paradoxical TE-IRIS and nine cases of unmasking TE-IRIS have been previously described. We present t...

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Autores principales: DiNardo, Andrew R, Lewis, Douglas Smoot, Koo, Hoonmo L, Goodman, J Clay, Chiao, Elizabeth, Andrade, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000Research 2013
Materias:
Clinical Practice Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3814919/
https://www.ncbi.nlm.nih.gov/pubmed/24358883
http://dx.doi.org/10.12688/f1000research.2-133.v1
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author DiNardo, Andrew R
Lewis, Douglas Smoot
Koo, Hoonmo L
Goodman, J Clay
Chiao, Elizabeth
Andrade, Roberto
author_facet DiNardo, Andrew R
Lewis, Douglas Smoot
Koo, Hoonmo L
Goodman, J Clay
Chiao, Elizabeth
Andrade, Roberto
author_sort DiNardo, Andrew R
collection PubMed
description Toxoplasma encephalitis immune reconstitution inflammatory syndrome (TE-IRIS) is rare and usually occurs in an unmasking, rather than paradoxical form. To the best of our knowledge, only two cases of paradoxical TE-IRIS and nine cases of unmasking TE-IRIS have been previously described. We present two additional cases of histopathology-consistent paradoxical TE-IRIS, after early initiation of antiretroviral therapy (ART), and review the literature on TE-IRIS. Three of the four reported cases of paradoxical TE-IRIS were associated with early (within one week) initiation of ART, an issue that was not addressed in the 2009 US Department of Health and Human Services guidelines for the treatment of opportunistic infections.
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spelling pubmed-38149192013-12-05 Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS DiNardo, Andrew R Lewis, Douglas Smoot Koo, Hoonmo L Goodman, J Clay Chiao, Elizabeth Andrade, Roberto F1000Res Clinical Practice Article Toxoplasma encephalitis immune reconstitution inflammatory syndrome (TE-IRIS) is rare and usually occurs in an unmasking, rather than paradoxical form. To the best of our knowledge, only two cases of paradoxical TE-IRIS and nine cases of unmasking TE-IRIS have been previously described. We present two additional cases of histopathology-consistent paradoxical TE-IRIS, after early initiation of antiretroviral therapy (ART), and review the literature on TE-IRIS. Three of the four reported cases of paradoxical TE-IRIS were associated with early (within one week) initiation of ART, an issue that was not addressed in the 2009 US Department of Health and Human Services guidelines for the treatment of opportunistic infections. F1000Research 2013-05-30 /pmc/articles/PMC3814919/ /pubmed/24358883 http://dx.doi.org/10.12688/f1000research.2-133.v1 Text en Copyright: © 2013 DiNardo AR et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Practice Article
DiNardo, Andrew R
Lewis, Douglas Smoot
Koo, Hoonmo L
Goodman, J Clay
Chiao, Elizabeth
Andrade, Roberto
Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS
title Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS
title_full Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS
title_fullStr Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS
title_full_unstemmed Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS
title_short Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS
title_sort paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis iris
topic Clinical Practice Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3814919/
https://www.ncbi.nlm.nih.gov/pubmed/24358883
http://dx.doi.org/10.12688/f1000research.2-133.v1
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