Review Note
Last Update: 04/01/2024 02:30 AM
Current Deck: Neurology::Genetics
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{{c1::Immune Reconstitution Inflammatory Syndrome (IRIS)}}: Syndrome occurring primarily in HIV-positive patients after initiating highly active antiretroviral therapy (HAART)
Notes
General IRIS manifestations:
- “Unmasking” (early): emergence of undiagnosed subclinical/asymptomatic opportunistic infection, usually within several months
- Laboratory-identifiable pathogen
- Damage caused by pathogen and exaggerated immune response
- Escalation of previously well-controlled infection (usually after 3 months), possibly occurring several years later (rare cases)
- Not attributable to identifiable pathogens
- Initial clinical improvement with decreasing HIV viral load after beginning HAART
- Unexpected onset of neurologic changes/ deterioration
- MRI: contrast enhancing lesions (caveat: absent in ~43% in early stages) Biopsy (current standard) evidence of CNS inflammation
- Other entities including drug toxicity ruled out
Mnemonic
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