PMID- 19902166
OWN - NLM
STAT- MEDLINE
DCOM- 20100223
LR  - 20221207
IS  - 1433-0407 (Electronic)
IS  - 0028-2804 (Linking)
VI  - 80
IP  - 12
DP  - 2009 Dec
TI  - [Severe aseptic leucoencephalopathy. Manifested as immune reconstitution 
      inflammatory syndrome in Caucasian and African patients].
PG  - 1496-51
LID - 10.1007/s00115-009-2839-5 [doi]
AB  - BACKGROUND: We hypothesize that CNS immune reconstitution inflammatory syndrome 
      (IRIS) after highly active antiretroviral therapy (HAART) in HIV-1-positive 
      patients may become manifest without any opportunistic infection as an aseptic 
      leucoencephalopathy. This opens a window of opportunity for successful treatment 
      with corticosteroids. DESIGN: We describe a case series of immunocompromised 
      HIV-1-positive patients who were started on HAART. All of them had clinical 
      laboratory follow-up tests and cerebral MRI in order to investigate the course 
      and the underlying pathophysiology of this aseptic form of IRIS. One African 
      patient died and we performed a neuropathological examination. RESULTS: No 
      infectious agent was detected before and during HAART. Three of four 
      immunocompromised patients were successfully treated with corticosteroids while 
      HAART was never interrupted and have survived up to now. One African patient died 
      within 2 days despite intensive care due to cerebral oedema. CONCLUSIONS: 
      Starting HAART, HIV-1-positive patients may develop an aseptic type of IRIS of 
      the CNS without any detectable opportunistic infection, a finding that has not 
      yet been published. This makes them susceptible for successful treatment with 
      corticosteroids. Perhaps IRIS has a higher incidence in African patients and the 
      patients have a poorer outcome than Caucasians.
FAU - Ringelstein, A
AU  - Ringelstein A
AD  - Institut fur Radiologie, Heinrich-Heine-Universitat Dusseldorf, Moorenstrasse 5, 
      Dusseldorf. a.ringelstein@gmx.de
FAU - Oelschlaeger, C
AU  - Oelschlaeger C
FAU - Arendt, G
AU  - Arendt G
FAU - Mathys, C
AU  - Mathys C
FAU - Dziewas, R
AU  - Dziewas R
FAU - Niederstadt, T
AU  - Niederstadt T
FAU - Reichelt, D
AU  - Reichelt D
FAU - Hasselblatt, M
AU  - Hasselblatt M
FAU - Husstedt, I W
AU  - Husstedt IW
FAU - Saleh, A
AU  - Saleh A
LA  - ger
PT  - Case Reports
PT  - Journal Article
PT  - Retracted Publication
TT  - Schwere Leukenzephalopathie. Manifestationsform des aseptischen 
      Immune-reconstitution-inflammatory-Syndroms bei Kaukasiern und Afrikanern.
PL  - Germany
TA  - Nervenarzt
JT  - Der Nervenarzt
JID - 0400773
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-HIV Agents)
SB  - IM
RIN - Nervenarzt. 2013 Aug;84(8):1003. PMID: 23955242
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Adult
MH  - Anti-HIV Agents/*adverse effects/therapeutic use
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - *Black People
MH  - Fatal Outcome
MH  - Female
MH  - HIV Infections/*drug therapy/immunology/virology
MH  - HIV-1
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/drug therapy/*immunology
MH  - Leukoencephalopathy, Progressive Multifocal/drug therapy/*immunology
MH  - Male
MH  - Middle Aged
MH  - *White People
EDAT- 2009/11/11 06:00
MHDA- 2010/02/24 06:00
CRDT- 2009/11/11 06:00
PHST- 2009/11/11 06:00 [entrez]
PHST- 2009/11/11 06:00 [pubmed]
PHST- 2010/02/24 06:00 [medline]
AID - 10.1007/s00115-009-2839-5 [doi]
PST - ppublish
SO  - Nervenarzt. 2009 Dec;80(12):1496-51. doi: 10.1007/s00115-009-2839-5.