PMID- 23324760
OWN - NLM
STAT- MEDLINE
DCOM- 20130311
LR  - 20220408
IS  - 2168-6084 (Electronic)
IS  - 2168-6068 (Print)
IS  - 2168-6068 (Linking)
VI  - 149
IP  - 1
DP  - 2013 Jan
TI  - Immune reconstitution reactions in human immunodeficiency virus-negative 
      patients: report of a case and review of the literature.
PG  - 74-8
LID - 10.1001/2013.jamadermatol.503 [doi]
AB  - BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) is a phenomenon 
      initially described in patients with human immunodeficiency virus. Upon 
      initiation of combination antiretroviral therapy, recovery of cellular immunity 
      triggers inflammation to a preexisting infection or antigen that causes 
      paradoxical worsening of clinical disease. A similar phenomenon can occur in 
      human immunodeficiency virus-negative patients, including pregnant women, 
      neutropenic hosts, solid-organ or stem cell transplant recipients, and patients 
      receiving tumor necrosis factor inhibitors. OBSERVATIONS: We report a case of 
      leprosy unmasking and downgrading reaction after stem cell transplantation that 
      highlights some of the challenges inherent to the diagnosis of IRIS, especially 
      in patients without human immunodeficiency virus infection, as well as review the 
      spectrum of previously reported cases of IRIS reactions in this population. 
      CONCLUSIONS: The mechanism of immune reconstitution reactions is complex and 
      variable, depending on the underlying antigen and the mechanism of 
      immunosuppression or shift in immune status. Use of the term IRIS can aid our 
      recognition of an important phenomenon that occurs in the setting of 
      immunosuppression or shifts in immunity but should not deter us from thinking 
      critically about the distinct processes that underlie this heterogeneous group of 
      conditions.
FAU - Scharschmidt, Tiffany C
AU  - Scharschmidt TC
AD  - Department of Dermatology, University of California, San Francisco 94115, USA.
FAU - Amerson, Erin H
AU  - Amerson EH
FAU - Rosenberg, Oren S
AU  - Rosenberg OS
FAU - Jacobs, Richard A
AU  - Jacobs RA
FAU - McCalmont, Timothy H
AU  - McCalmont TH
FAU - Shinkai, Kanade
AU  - Shinkai K
LA  - eng
GR  - K08 AI091656/AI/NIAID NIH HHS/United States
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - JAMA Dermatol
JT  - JAMA dermatology
JID - 101589530
SB  - IM
MH  - HIV Seronegativity
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*diagnosis/pathology
MH  - Leprosy/*diagnosis/pathology
MH  - Male
MH  - Middle Aged
MH  - Stem Cell Transplantation/*adverse effects/methods
PMC - PMC3773570
MID - NIHMS505676
EDAT- 2013/01/18 06:00
MHDA- 2013/03/12 06:00
PMCR- 2013/09/16
CRDT- 2013/01/18 06:00
PHST- 2013/01/18 06:00 [entrez]
PHST- 2013/01/18 06:00 [pubmed]
PHST- 2013/03/12 06:00 [medline]
PHST- 2013/09/16 00:00 [pmc-release]
AID - 1557768 [pii]
AID - 10.1001/2013.jamadermatol.503 [doi]
PST - ppublish
SO  - JAMA Dermatol. 2013 Jan;149(1):74-8. doi: 10.1001/2013.jamadermatol.503.