PMID- 22891230
OWN - NLM
STAT- MEDLINE
DCOM- 20121109
LR  - 20120903
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 130
IP  - 3
DP  - 2012 Sep
TI  - Acute poststreptococcal glomerulonephritis: a manifestation of immune 
      reconstitution inflammatory syndrome.
PG  - e710-3
LID - 10.1542/peds.2011-1246 [doi]
AB  - Immune reconstitution inflammatory syndrome (IRIS) is a well-described 
      complication of initiation of highly active antiretroviral therapy in 
      HIV-infected patients. As the immune system recovers, an inappropriate 
      inflammatory response often occurs that causes significant disease. It is most 
      commonly seen in patients naive to therapy with CD4+ T-lymphocyte counts <100 
      cells/cmm and usually presents as a flare of mycobacterial, cytomegalovirus, or 
      herpes zoster infections. Less commonly, this syndrome occurs in response to 
      noninfectious triggers and results in autoimmune or malignant disease. Here we 
      present the first case of acute poststreptococcal glomerulonephritis associated 
      with varicella zoster virus and IRIS in an adolescent with perinatally acquired 
      HIV and hepatitis C virus infections. Our patient was not naive to therapy but 
      was starting a new regimen of therapy because of virologic failure and had a 
      relatively high CD4+ T-lymphocyte count. This case report indicates that IRIS 
      remains a concern after initiation of a new highly active antiretroviral therapy 
      regimen in HIV-infected patients with high viral loads, even in the presence of 
      CD4+ T-lymphocyte counts >100 cells/cmm. It may present as infectious, malignant, 
      or autoimmune conditions including poststreptococcal glomerulonephritis.
FAU - Martin, Julie
AU  - Martin J
AD  - he Saul Krugman Division of Pediatric Infectious Diseases, New York University 
      School of Medicine/Bellevue Hospital, New York, New York 10016, USA. 
      julie.martin@nyumc.org
FAU - Kaul, Aditya
AU  - Kaul A
FAU - Schacht, Robert
AU  - Schacht R
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20120813
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Antiretroviral Therapy, Highly Active/adverse effects
MH  - Glomerulonephritis/*complications/diagnosis
MH  - HIV Infections/*complications/drug therapy/immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*diagnosis/etiology
MH  - Male
MH  - Pharyngitis/complications/diagnosis
MH  - Streptococcal Infections/*complications/diagnosis
MH  - *Streptococcus pyogenes
EDAT- 2012/08/15 06:00
MHDA- 2012/11/10 06:00
CRDT- 2012/08/15 06:00
PHST- 2012/08/15 06:00 [entrez]
PHST- 2012/08/15 06:00 [pubmed]
PHST- 2012/11/10 06:00 [medline]
AID - peds.2011-1246 [pii]
AID - 10.1542/peds.2011-1246 [doi]
PST - ppublish
SO  - Pediatrics. 2012 Sep;130(3):e710-3. doi: 10.1542/peds.2011-1246. Epub 2012 Aug 
      13.