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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Immune reconstitution inflammatory syndrome (IRIS)
Synonyms
- Neuro-IRIS
Definitions
- Dysregulated immune response with worsening/unmasking of preexisting opportunist infection
- After starting antiretroviral therapy (ART)
- Patients with multiple sclerosis (MS), immunomodulatory therapy
- Dysregulated immune response with worsening/unmasking of preexisting opportunist infection
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Bartsch T et al: The spectrum of progressive multifocal leukoencephalopathy: a practical approach. Eur J Neurol. 26(4):566-e41, 2019
- Bowen L et al: CNS immune reconstitution inflammatory syndrome. Handb Clin Neurol. 152:167-76, 2018
- Dellière S et al: Understanding pathogenesis and care challenges of immune reconstitution inflammatory syndrome in fungal infections. J Fungi (Basel). 4(4), 2018
- Sueki H et al: Immune reconstitution inflammatory syndrome in non-HIV immunosuppressed patients. J Dermatol. 45(1):3-9, 2018
- Calic Z et al: Treatment of progressive multifocal leukoencephalopathy-immune reconstitution inflammatory syndrome with intravenous immunoglobulin in a patient with multiple sclerosis treated with fingolimod after discontinuation of natalizumab. J Clin Neurosci. 22(3):598-600, 2015
- Post MJ et al: CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 1: overview and discussion of progressive multifocal leukoencephalopathy-immune reconstitution inflammatory syndrome and cryptococcal-immune reconstitution inflammatory syndrome. AJNR Am J Neuroradiol. 34(7):1297-307, 2013
- Post MJ et al: CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 2: discussion of neuro-immune reconstitution inflammatory syndrome with and without other pathogens. AJNR Am J Neuroradiol. 34(7):1308-18, 2013
- Kranick SM et al: Neurologic complications of HIV-1 infection and its treatment in the era of antiretroviral therapy. Continuum (Minneap Minn). 18(6 Infectious Disease):1319-37, 2012
- Major EO: Progressive multifocal leukoencephalopathy in patients on immunomodulatory therapies. Annu Rev Med. 61:35-47, 2010
- Elston JW et al: Immune reconstitution inflammatory syndrome. Int J STD AIDS. 20(4):221-4, 2009
- McCombe JA et al: Neurologic immune reconstitution inflammatory syndrome in HIV/AIDS: outcome and epidemiology. Neurology. 72(9):835-41, 2009
- Pepper DJ et al: Neurologic manifestations of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome: a case series. Clin Infect Dis. 48(11):e96-107, 2009
- Smith AB et al: From the archives of the AFIP: central nervous system infections associated with human immunodeficiency virus infection: radiologic-pathologic correlation. Radiographics. 2008 Nov-Dec;28(7):2033-58. Review. Erratum in: Radiographics. 29(2):638, 2009
- Sun HY et al: Immune reconstitution inflammatory syndrome in non-HIV immunocompromised patients. Curr Opin Infect Dis. 22(4):394-402, 2009
- Tan K et al: PML-IRIS in patients with HIV infection: clinical manifestations and treatment with steroids. Neurology. 72(17):1458-64, 2009
- Tremont-Lukats IW et al: The immune inflammatory reconstitution syndrome and central nervous system toxoplasmosis. Ann Intern Med. 150(9):656-7, 2009
- Meintjes G et al: Prevention and treatment of the immune reconstitution inflammatory syndrome. Curr Opin HIV AIDS. 3(4):468-76, 2008
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Immune reconstitution inflammatory syndrome (IRIS)
Synonyms
- Neuro-IRIS
Definitions
- Dysregulated immune response with worsening/unmasking of preexisting opportunist infection
- After starting antiretroviral therapy (ART)
- Patients with multiple sclerosis (MS), immunomodulatory therapy
- Dysregulated immune response with worsening/unmasking of preexisting opportunist infection
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
- Bartsch T et al: The spectrum of progressive multifocal leukoencephalopathy: a practical approach. Eur J Neurol. 26(4):566-e41, 2019
- Bowen L et al: CNS immune reconstitution inflammatory syndrome. Handb Clin Neurol. 152:167-76, 2018
- Dellière S et al: Understanding pathogenesis and care challenges of immune reconstitution inflammatory syndrome in fungal infections. J Fungi (Basel). 4(4), 2018
- Sueki H et al: Immune reconstitution inflammatory syndrome in non-HIV immunosuppressed patients. J Dermatol. 45(1):3-9, 2018
- Calic Z et al: Treatment of progressive multifocal leukoencephalopathy-immune reconstitution inflammatory syndrome with intravenous immunoglobulin in a patient with multiple sclerosis treated with fingolimod after discontinuation of natalizumab. J Clin Neurosci. 22(3):598-600, 2015
- Post MJ et al: CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 1: overview and discussion of progressive multifocal leukoencephalopathy-immune reconstitution inflammatory syndrome and cryptococcal-immune reconstitution inflammatory syndrome. AJNR Am J Neuroradiol. 34(7):1297-307, 2013
- Post MJ et al: CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 2: discussion of neuro-immune reconstitution inflammatory syndrome with and without other pathogens. AJNR Am J Neuroradiol. 34(7):1308-18, 2013
- Kranick SM et al: Neurologic complications of HIV-1 infection and its treatment in the era of antiretroviral therapy. Continuum (Minneap Minn). 18(6 Infectious Disease):1319-37, 2012
- Major EO: Progressive multifocal leukoencephalopathy in patients on immunomodulatory therapies. Annu Rev Med. 61:35-47, 2010
- Elston JW et al: Immune reconstitution inflammatory syndrome. Int J STD AIDS. 20(4):221-4, 2009
- McCombe JA et al: Neurologic immune reconstitution inflammatory syndrome in HIV/AIDS: outcome and epidemiology. Neurology. 72(9):835-41, 2009
- Pepper DJ et al: Neurologic manifestations of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome: a case series. Clin Infect Dis. 48(11):e96-107, 2009
- Smith AB et al: From the archives of the AFIP: central nervous system infections associated with human immunodeficiency virus infection: radiologic-pathologic correlation. Radiographics. 2008 Nov-Dec;28(7):2033-58. Review. Erratum in: Radiographics. 29(2):638, 2009
- Sun HY et al: Immune reconstitution inflammatory syndrome in non-HIV immunocompromised patients. Curr Opin Infect Dis. 22(4):394-402, 2009
- Tan K et al: PML-IRIS in patients with HIV infection: clinical manifestations and treatment with steroids. Neurology. 72(17):1458-64, 2009
- Tremont-Lukats IW et al: The immune inflammatory reconstitution syndrome and central nervous system toxoplasmosis. Ann Intern Med. 150(9):656-7, 2009
- Meintjes G et al: Prevention and treatment of the immune reconstitution inflammatory syndrome. Curr Opin HIV AIDS. 3(4):468-76, 2008
