Immune reconstitution inflammatory syndrome in the lung in non-human immunodeficiency virus patients |
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| Affiliation: | 1. Division of Pulmonary and Critical Care Medicine, Allegheny General Hospital, 320 E North Avenue, Pittsburgh, 15212 PA, USA;2. Department of Internal Medicine, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, USA;3. Division of Pulmonary and Critical Care Medicine, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, USA;1. Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil;2. Serviço de Anatomia, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil;3. Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain;1. Geneva university hospitals, division of general internal medicine, 1205 Geneva, Switzerland;2. Geneva university hospitals, division of infectious diseases, 1205 Geneva, Switzerland;3. Geneva university hospitals, division of hematology, 1205 Geneva, Switzerland;4. Geneva university hospitals, division of tropical and humanitarian medicine, 1205 Geneva, Switzerland |
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| Abstract: | BackgroundWe evaluated immune reconstitution inflammatory syndrome (IRIS) in the lung in non-human immunodeficiency virus (HIV) patients.MethodsWe reviewed articles related to IRIS occurrence in the lung in non-HIV patients using a PubMed search. The keywords used for the search were “immune reconstitution syndrome” and “non-HIV.” Only patients with lung involvement were included. Those with suggested IRIS caused by white blood cell recovery were excluded.ResultsThere were 37 cases of IRIS in the lung in non-HIV patients. Complicating infections included tuberculosis (n = 17), histoplasmosis (n = 9), aspergillosis (n = 5), cryptococcosis (n = 4), and Pneumocystis pneumonia (n = 2). We also evaluated the underlying diseases, IRIS pathogenesis, management, and prognosis. IRIS was most commonly encountered in patients treated with anti-tumor necrosis factor (TNF) antibody who developed disseminated or extrapulmonary tuberculosis, leading to treatment discontinuation.ConclusionsThe diagnosis and management of IRIS in the lung in non-HIV patients should be investigated further, especially in the era of anti-TNF treatment. |
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| Keywords: | Immune reconstitution inflammatory syndrome Lung Non-HIV patients Anti-tumor necrosis factor |
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