PMID- 16978978
OWN - NLM
STAT- MEDLINE
DCOM- 20061130
LR  - 20161124
IS  - 0009-9260 (Print)
IS  - 0009-9260 (Linking)
VI  - 61
IP  - 10
DP  - 2006 Oct
TI  - The radiology of IRIS (immune reconstitution inflammatory syndrome) in patients 
      with mycobacterial tuberculosis and HIV co-infection: Appearances in 11 patients.
PG  - 833-43
AB  - AIM: To determine the radiological manifestations of IRIS (immune reconstitution 
      inflammatory syndrome) in patients with HIV and mycobacterium tuberculosis 
      co-infection, in the context of their demographic and clinical data. MATERIALS 
      AND METHODS: The radiological imaging, demographic and clinical data of 11 
      patients diagnosed with IRIS associated with HIV and mycobacterial tuberculosis 
      co-infection were studied retrospectively. Where available, follow-up imaging 
      studies were also reviewed. RESULTS: The most common radiological feature of IRIS 
      was lymph node enlargement (73%), with central low attenuation centres, in 
      keeping with necrosis, present in most of these cases (88%). Most commonly 
      affected were intra-abdominal nodes (70%), followed by axillary (40%) and 
      mediastinal lymph nodes (36%). Within the lung parenchyma, diffuse, bilateral 
      pulmonary nodules were seen in 55% of cases. Unilateral small volume pleural 
      effusions were seen in two cases with associated parenchymal changes seen in only 
      one. Small volume ascites was seen in two cases. Thirty-six percent of cases 
      presented with new or worsening abscesses despite treatment. In this context, 
      image-guided radiological drainage proved a useful adjunct to the conventional 
      medical therapy for IRIS. The most common clinical signs of IRIS included fever 
      (64%), abdominal pain (36%) and cough (27%). CONCLUSION: We have described the 
      radiological features that are characteristic in IRIS and the importance of 
      putting these into context with the clinical and pathological findings as part of 
      a multidisciplinary approach in making the diagnosis. The role of the radiologist 
      is central in diagnosis, monitoring of disease progression and management of 
      complications in patients with IRIS.
FAU - Rajeswaran, G
AU  - Rajeswaran G
AD  - Department of Radiology, Chelsea and Westminster Hospital, London, UK. 
      grajeswaran@hotmail.com
FAU - Becker, J L
AU  - Becker JL
FAU - Michailidis, C
AU  - Michailidis C
FAU - Pozniak, A L
AU  - Pozniak AL
FAU - Padley, S P G
AU  - Padley SP
LA  - eng
PT  - Journal Article
PL  - England
TA  - Clin Radiol
JT  - Clinical radiology
JID - 1306016
SB  - IM
MH  - Adult
MH  - HIV Infections/complications/*diagnostic imaging/immunology
MH  - Humans
MH  - Immune System Diseases/complications/*diagnostic imaging/immunology
MH  - Inflammation/diagnostic imaging/immunology
MH  - Male
MH  - Mycobacterium tuberculosis/immunology
MH  - Retrospective Studies
MH  - Syndrome
MH  - Tomography, X-Ray Computed
MH  - Tuberculosis, Lymph Node/diagnostic imaging
MH  - Tuberculosis, Pulmonary/complications/*diagnostic imaging/immunology
EDAT- 2006/09/19 09:00
MHDA- 2006/12/09 09:00
CRDT- 2006/09/19 09:00
PHST- 2006/02/16 00:00 [received]
PHST- 2006/04/16 00:00 [revised]
PHST- 2006/04/20 00:00 [accepted]
PHST- 2006/09/19 09:00 [pubmed]
PHST- 2006/12/09 09:00 [medline]
PHST- 2006/09/19 09:00 [entrez]
AID - S0009-9260(06)00130-9 [pii]
AID - 10.1016/j.crad.2006.04.007 [doi]
PST - ppublish
SO  - Clin Radiol. 2006 Oct;61(10):833-43. doi: 10.1016/j.crad.2006.04.007.