PMID- 19770685
OWN - NLM
STAT- MEDLINE
DCOM- 20100125
LR  - 20111006
IS  - 1536-3678 (Electronic)
IS  - 1077-4114 (Linking)
VI  - 31
IP  - 10
DP  - 2009 Oct
TI  - Adjuvant corticosteroid therapy in 2 children with hepatosplenic 
      candidiasis-related IRIS.
PG  - 794-6
LID - 10.1097/MPH.0b013e3181b795ec [doi]
AB  - First described in HIV-infected patients who recently initiated highly active 
      antiretroviral therapy, the immune reconstitution inflammatory syndrome (IRIS) is 
      best characterized as a collection of inflammatory disorders triggered by rapid 
      resolution of immunosuppression. Treatment of IRIS is a clinical challenge due to 
      the variety of clinical presentations and the presence of multiple pathogens 
      capable of causing the syndrome. Hepatosplenic candidiasis, an uncommon form of 
      invasive Candida species infection, was recently suggested to belong to the 
      spectrum of fungus-related IRIS. We report 2 cases of probable hepatosplenic 
      candidiasis according to the guidelines of the European Organization for Research 
      and Treatment of Cancer and the Mycosis Study Group, occurring in pediatric 
      patients with acute leukemia during rapid neutrophil recovery after cytotoxic 
      chemotherapy. In both cases, abdominal computed tomography scan revealed multiple 
      hepatic micronodules, and liver biopsy showed nonspecific granulomatous lesions. 
      Hepatosplenic candidiasis symptoms (fever, nausea and vomiting, abdominal pain) 
      resolved within 2 days after adjunction of corticosteroid therapy to antifungal 
      treatment. Inflammatory markers and related radiologic abnormalities decreased or 
      disappeared within 1 month. Recovery of neutrophil count in a context of 
      hepatosplenic candidiasis may result in a heightened inflammatory response. 
      Corticosteroid therapy in this setting is associated with prompt resolution of 
      the symptoms.
FAU - Saint-Faust, Marie
AU  - Saint-Faust M
AD  - Department of Pediatric Hematology-Oncology, Universitary Hospital L'Archet, 
      Nice, France. mariestfaust@hotmail.fr
FAU - Boyer, Corinne
AU  - Boyer C
FAU - Gari-Toussaint, Martine
AU  - Gari-Toussaint M
FAU - Deville, Anne
AU  - Deville A
FAU - Poiree, Maryline
AU  - Poiree M
FAU - Weintraub, Mickael
AU  - Weintraub M
FAU - Sirvent, Nicolas
AU  - Sirvent N
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - J Pediatr Hematol Oncol
JT  - Journal of pediatric hematology/oncology
JID - 9505928
RN  - 0 (Adrenal Cortex Hormones)
SB  - IM
MH  - Adrenal Cortex Hormones/*therapeutic use
MH  - Candidiasis/*complications
MH  - Chemotherapy, Adjuvant
MH  - Child
MH  - Female
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*etiology
MH  - Liver Diseases/microbiology
MH  - Male
MH  - Remission Induction
MH  - Splenic Diseases/microbiology
EDAT- 2009/09/23 06:00
MHDA- 2010/01/26 06:00
CRDT- 2009/09/23 06:00
PHST- 2009/09/23 06:00 [entrez]
PHST- 2009/09/23 06:00 [pubmed]
PHST- 2010/01/26 06:00 [medline]
AID - 10.1097/MPH.0b013e3181b795ec [doi]
PST - ppublish
SO  - J Pediatr Hematol Oncol. 2009 Oct;31(10):794-6. doi: 
      10.1097/MPH.0b013e3181b795ec.