Dysregulated immune response with worsening/unmasking of preexisting opportunist infection
After starting antiretroviral therapy (ART)
Patients with multiple sclerosis (MS), immunomodulatory therapy
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
Dysregulated immune response with worsening/unmasking of preexisting opportunist infection
After starting antiretroviral therapy (ART)
Patients with multiple sclerosis (MS), immunomodulatory therapy
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
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