PMID- 35820900
OWN - NLM
STAT- MEDLINE
DCOM- 20220714
LR  - 20220801
IS  - 1471-2431 (Electronic)
IS  - 1471-2431 (Linking)
VI  - 22
IP  - 1
DP  - 2022 Jul 12
TI  - Pneumocystis jirovecii-associated immune reconstitution inflammatory 
      syndrome-like phenomenon in a child with leukaemia: a case report and literature 
      review.
PG  - 410
LID - 10.1186/s12887-022-03441-9 [doi]
LID - 410
AB  - BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) refers to the 
      phenomenon of intense immune responses against pathogens in patients with AIDS 
      undergoing antiretroviral therapy to reconstitute immune function, resulting in 
      functional impairment of multiple organs. Non-AIDS immunosuppressed hosts may 
      also develop similar manifestations to IRIS during immune recovery. CASE 
      PRESENTATION: An 8-year-old girl presented with acute lymphoblastic leukaemia was 
      admitted for scheduled chemotherapy treatment. During chemotherapy, she 
      experienced pancytopenia and Pneumocystis jirovecii pneumonia, which was 
      diagnosed based on the abnormal shadows observed on chest computed tomography, 
      the elevation of serum beta-D-glucan, and the positive mNGS results of Pneumocystis 
      jirovecii in both sputum and blood. After treatment with Granulocyte 
      Colony-Stimulating Factor, sulfamethoxazole, and caspofungin, aggravation of lung 
      lesions was discovered and severe interstitial lung disease developed in a short 
      period along with a rapidly increasing leukocyte count. Intravenous 
      methylprednisolone pulse therapy was given, but lung function did not improve, 
      and she finally died after the withdrawal of medical care. CONCLUSIONS: For 
      patients with acute lymphocytic leukaemia infected with Pneumocystis jirovecii, 
      the rapid aggravation of pulmonary lesions in the process of blood recovery and 
      immune reconstitution should raise vigilance against the possibility of IRIS-like 
      reactions. The use of granulocyte stimulating factors may aggravate the 
      inflammatory response in the lungs. The timing, dosage, and duration of treatment 
      of glucocorticoids and the impact of high-dose methylprednisolone pulse therapy 
      on the prognosis of patients should be explored in further research.
CI  - (c) 2022. The Author(s).
FAU - Lei, Jia-Ying
AU  - Lei JY
AD  - Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong 
      Higher Education Institutes, Sun Yat-Sen University, Guangzhou, People's Republic 
      of China.
AD  - Children's Medical Center, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen 
      University, Guangzhou, 510120, People's Republic of China.
FAU - Chen, Han
AU  - Chen H
AD  - Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong 
      Higher Education Institutes, Sun Yat-Sen University, Guangzhou, People's Republic 
      of China.
AD  - Children's Medical Center, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen 
      University, Guangzhou, 510120, People's Republic of China.
FAU - Zhou, Dun-Hua
AU  - Zhou DH
AD  - Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong 
      Higher Education Institutes, Sun Yat-Sen University, Guangzhou, People's Republic 
      of China.
AD  - Children's Medical Center, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen 
      University, Guangzhou, 510120, People's Republic of China.
FAU - Xu, Lu-Hong
AU  - Xu LH
AD  - Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong 
      Higher Education Institutes, Sun Yat-Sen University, Guangzhou, People's Republic 
      of China.
AD  - Children's Medical Center, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen 
      University, Guangzhou, 510120, People's Republic of China.
FAU - Fang, Jian-Pei
AU  - Fang JP
AD  - Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong 
      Higher Education Institutes, Sun Yat-Sen University, Guangzhou, People's Republic 
      of China.
AD  - Children's Medical Center, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen 
      University, Guangzhou, 510120, People's Republic of China.
FAU - Mai, You-Gang
AU  - Mai YG
AUID- ORCID: 0000-0002-7835-2642
AD  - Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong 
      Higher Education Institutes, Sun Yat-Sen University, Guangzhou, People's Republic 
      of China. maiyg@mail.sysu.edu.cn.
AD  - Children's Medical Center, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen 
      University, Guangzhou, 510120, People's Republic of China. 
      maiyg@mail.sysu.edu.cn.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20220712
PL  - England
TA  - BMC Pediatr
JT  - BMC pediatrics
JID - 100967804
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Child
MH  - Female
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome/diagnosis/etiology
MH  - *Leukemia
MH  - Methylprednisolone
MH  - *Pneumocystis carinii
MH  - *Pneumonia, Pneumocystis/complications/diagnosis/drug therapy
PMC - PMC9277966
OTO - NOTNLM
OT  - Acute lymphocytic leukaemia
OT  - Immune reconstitution inflammatory syndrome-like phenomenon
OT  - Pneumocystis Jirovecii pneumonia
COIS- All authors declare that they have no competing interests.
EDAT- 2022/07/13 06:00
MHDA- 2022/07/15 06:00
PMCR- 2022/07/12
CRDT- 2022/07/12 23:38
PHST- 2021/10/25 00:00 [received]
PHST- 2022/06/21 00:00 [accepted]
PHST- 2022/07/12 23:38 [entrez]
PHST- 2022/07/13 06:00 [pubmed]
PHST- 2022/07/15 06:00 [medline]
PHST- 2022/07/12 00:00 [pmc-release]
AID - 10.1186/s12887-022-03441-9 [pii]
AID - 3441 [pii]
AID - 10.1186/s12887-022-03441-9 [doi]
PST - epublish
SO  - BMC Pediatr. 2022 Jul 12;22(1):410. doi: 10.1186/s12887-022-03441-9.