Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: Two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS

Andrew R. DiNardo; Douglas Smoot Lewis; Hoonmo L. Koo; J. Clay Goodman; Elizabeth Chiao; Roberto Andrade

doi:10.12688/f1000research.2-133.v1

Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: Two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS

Andrew R. DiNardo, Douglas Smoot Lewis, Hoonmo L. Koo, J. Clay Goodman, Elizabeth Chiao, Roberto Andrade

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5 Scopus citations

Abstract

Toxoplasma encephalitis immune reconstitution inflammatory syndrome (TE-IRIS) is rare and usually occurs in an unmasking, rather than paradoxical form. To the best of our knowledge, only two cases of paradoxical TE-IRIS and nine cases of unmasking TE-IRIS have been previously described. We present two additional cases of histopathology-consistent paradoxical TE-IRIS, after early initiation of antiretroviral therapy (ART), and review the literature on TE-IRIS. Three of the four reported cases of paradoxical TE-IRIS were associated with early (within one week) initiation of ART, an issue that was not addressed in the 2009 US Department of Health and Human Services guidelines for the treatment of opportunistic infections.

Original language	English (US)
Article number	133
Journal	F1000Research
Volume	2
Issue number	1
DOIs	https://doi.org/10.12688/f1000research.2-133.v1
State	Published - May 30 2013
Externally published	Yes

ASJC Scopus subject areas

General Biochemistry, Genetics and Molecular Biology
General Immunology and Microbiology
Pharmacology, Toxicology and Pharmaceutics(all)

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abstract = "Toxoplasma encephalitis immune reconstitution inflammatory syndrome (TE-IRIS) is rare and usually occurs in an unmasking, rather than paradoxical form. To the best of our knowledge, only two cases of paradoxical TE-IRIS and nine cases of unmasking TE-IRIS have been previously described. We present two additional cases of histopathology-consistent paradoxical TE-IRIS, after early initiation of antiretroviral therapy (ART), and review the literature on TE-IRIS. Three of the four reported cases of paradoxical TE-IRIS were associated with early (within one week) initiation of ART, an issue that was not addressed in the 2009 US Department of Health and Human Services guidelines for the treatment of opportunistic infections.",

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AU - Lewis, Douglas Smoot

AU - Koo, Hoonmo L.

AU - Goodman, J. Clay

AU - Chiao, Elizabeth

AU - Andrade, Roberto

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Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: Two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS

Abstract

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