PMID- 25887769
OWN - NLM
STAT- MEDLINE
DCOM- 20160115
LR  - 20181113
IS  - 1473-6551 (Electronic)
IS  - 1350-7540 (Print)
IS  - 1350-7540 (Linking)
VI  - 28
IP  - 3
DP  - 2015 Jun
TI  - Neurological immune reconstitution inflammatory response: riding the tide of 
      immune recovery.
PG  - 295-301
LID - 10.1097/WCO.0000000000000200 [doi]
AB  - PURPOSE OF REVIEW: This manuscript reviews current reports about clinical aspects 
      of immune reconstitution inflammatory syndrome (IRIS), with a particular emphasis 
      on IRIS in the setting of progressive multifocal leukoencephalopathy (PML) and to 
      a lesser extent on cryptococcal meningitis and HIV. RECENT FINDINGS: PML 
      prognosis has been radically improved, as it has become possible to provide 
      immune reconstitution, although some remaining morbidity and mortality results 
      from excess inflammation. Similar pathologic responses are seen less often, but 
      remain clinically important in cryptococcal meningitis, and HIV. Early diagnosis 
      and active management of PML results in optimal outcomes with survival of 75% or 
      higher in multiple recent series. These finding apply both to natalizumab and 
      HIV-associated PML. Cryptococcal meningitis is frequently complicated by IRIS, 
      and early treatment with antifungal therapy preceding HIV therapy provides 
      optimal outcomes. HIV IRIS is reduced by early therapy, which is now recommended, 
      but even on therapy, chronic dysregulated immune responses may play important 
      roles in ongoing HIV-associated neurocognitive disease (HAND), which is common, 
      as well as rare but more dramatic subacute encephalopathies. SUMMARY: The 
      clinician must actively monitor and treat both opportunistic infection and the 
      inflammatory response that is essential to recovery but may itself augment 
      disease and injury.
FAU - Clifford, David B
AU  - Clifford DB
AD  - Department of Neurology, Washington University, St. Louis, Missouri, USA.
LA  - eng
GR  - U01 AI025903/AI/NIAID NIH HHS/United States
GR  - U10 NS077384/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Review
PL  - England
TA  - Curr Opin Neurol
JT  - Current opinion in neurology
JID - 9319162
SB  - IM
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*complications/*immunology
MH  - *Immune System/immunology/pathology/physiopathology
MH  - Nervous System Diseases/*etiology
PMC - PMC4414899
MID - NIHMS674783
EDAT- 2015/04/19 06:00
MHDA- 2016/01/16 06:00
PMCR- 2016/06/01
CRDT- 2015/04/19 06:00
PHST- 2015/04/19 06:00 [entrez]
PHST- 2015/04/19 06:00 [pubmed]
PHST- 2016/01/16 06:00 [medline]
PHST- 2016/06/01 00:00 [pmc-release]
AID - 10.1097/WCO.0000000000000200 [doi]
PST - ppublish
SO  - Curr Opin Neurol. 2015 Jun;28(3):295-301. doi: 10.1097/WCO.0000000000000200.