PMID- 21159113
OWN - NLM
STAT- MEDLINE
DCOM- 20111017
LR  - 20141120
IS  - 1399-3062 (Electronic)
IS  - 1398-2273 (Linking)
VI  - 13
IP  - 3
DP  - 2011 Jun
TI  - Immune reconstitution inflammatory syndrome mimicking relapsing cryptococcal 
      meningitis in a renal transplant recipient.
PG  - 303-8
LID - 10.1111/j.1399-3062.2010.00592.x [doi]
AB  - Immune reconstitution inflammatory syndrome (IRIS) is a rare entity that has been 
      described recently in solid organ transplant (SOT) recipients. IRIS is 
      characterized by an exuberant and dysregulated immune response following 
      treatment of opportunistic infections. We describe here the case of a kidney 
      transplant recipient who developed cryptococcal meningitis that was efficiently 
      treated with antifungal therapy and decreased immunosuppression regimen. Eight 
      months later, a paradoxical worsening of neurological symptoms and 
      neuroradiological findings led to the diagnosis of IRIS. A short course of 
      high-dose steroid therapy allowed complete resolution of neurological symptoms. 
      This report highlights the challenge for physicians to distinguish IRIS from a 
      relapsing cryptococcal infection. Clinical improvement of 
      cryptococcosis-associated IRIS by anti-inflammatory drugs needs to be confirmed 
      among SOT recipients.
CI  - (c) 2010 John Wiley & Sons A/S.
FAU - Legris, T
AU  - Legris T
AD  - Centre de Nephrologie et Transplantation Renale, Universite de la Mediterranee, 
      Assistance Publique des Hopitaux de Marseille, Hopital Conception, Marseille, 
      France. tristan.legris@ap-hm.fr
FAU - Massad, M
AU  - Massad M
FAU - Purgus, R
AU  - Purgus R
FAU - Vacher-Coponat, H
AU  - Vacher-Coponat H
FAU - Ranque, S
AU  - Ranque S
FAU - Girard, N
AU  - Girard N
FAU - Berland, Y
AU  - Berland Y
FAU - Moal, V
AU  - Moal V
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20101216
PL  - Denmark
TA  - Transpl Infect Dis
JT  - Transplant infectious disease : an official journal of the Transplantation 
      Society
JID - 100883688
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Antifungal Agents)
SB  - IM
MH  - Adrenal Cortex Hormones/*therapeutic use
MH  - Antifungal Agents/therapeutic use
MH  - Diagnosis, Differential
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*diagnosis/*drug therapy/etiology
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Meningitis, Cryptococcal/complications/*diagnosis/drug therapy/microbiology
MH  - Middle Aged
MH  - Secondary Prevention
MH  - Treatment Outcome
EDAT- 2010/12/17 06:00
MHDA- 2011/10/18 06:00
CRDT- 2010/12/17 06:00
PHST- 2010/12/17 06:00 [entrez]
PHST- 2010/12/17 06:00 [pubmed]
PHST- 2011/10/18 06:00 [medline]
AID - 10.1111/j.1399-3062.2010.00592.x [doi]
PST - ppublish
SO  - Transpl Infect Dis. 2011 Jun;13(3):303-8. doi: 10.1111/j.1399-3062.2010.00592.x. 
      Epub 2010 Dec 16.