Immune reconstitution inflammatory syndrome (IRIS): Case series and review of the literature
Background: Immune-reconstitution inflammatory syndrome (IRIS) is a dysregulated host inflammatory response following the initiation of appropriate therapy targeting an infectious disease. It is most commonly reported in human immunodeficiency virus patients following the initiation of antiretrovira...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Respiratory Medicine Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007125000498 |
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| author | Sebastian Schregenberger Vera Graup Adrian Schibli Benjamin Preiswerk Irène Laube Lars C. Huber Melina Stüssi-Helbling |
| author_facet | Sebastian Schregenberger Vera Graup Adrian Schibli Benjamin Preiswerk Irène Laube Lars C. Huber Melina Stüssi-Helbling |
| author_sort | Sebastian Schregenberger |
| collection | DOAJ |
| description | Background: Immune-reconstitution inflammatory syndrome (IRIS) is a dysregulated host inflammatory response following the initiation of appropriate therapy targeting an infectious disease. It is most commonly reported in human immunodeficiency virus patients following the initiation of antiretroviral therapy; however, IRIS can also be seen in immunocompromised patients without HIV, when the immune system is recovering. The diagnosis is confirmed using clinical and laboratory data after excluding differential diagnoses and concomitant infections. Case series: Here, we describe three cases of patients with IRIS that were treated at our tertiary care center. The first case involves a paradoxical IRIS in an HIV-positive patient with TB, where the re-initiation of ART led to an inflammatory response despite effective anti-tuberculous treatment (ATT). The second case highlights unmasking IRIS in an HIV-positive patient, where the initiation of ART revealed an underlying Epstein-Barr virus (EBV)-associated B-cell lymphoma. The third case describes paradoxical worsening of pulmonary TB in an HIV-negative patient, expanding the scope of IRIS beyond its conventional association with HIV infection. Conclusion: These cases illustrate the various manifestations of IRIS and emphasize the need for timely diagnosis and appropriate management strategies to mitigate the potentially severe outcomes associated with this syndrome. Our report highlights the challenges faced in the diagnosis of IRIS which impede prompt onset of therapy. |
| format | Article |
| id | doaj-art-c1b2568dd45b439db1b95dc0b4136b92 |
| institution | Kabale University |
| issn | 2213-0071 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj-art-c1b2568dd45b439db1b95dc0b4136b922025-08-20T03:48:47ZengElsevierRespiratory Medicine Case Reports2213-00712025-01-015510221310.1016/j.rmcr.2025.102213Immune reconstitution inflammatory syndrome (IRIS): Case series and review of the literatureSebastian Schregenberger0Vera Graup1Adrian Schibli2Benjamin Preiswerk3Irène Laube4Lars C. Huber5Melina Stüssi-Helbling6Department of Surgery, Division of Emergency Medicine, Hospital Buelach, Spitalstrasse 24, 8180, Buelach, SwitzerlandDepartment of Cardiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, SwitzerlandDepartment of Internal Medicine, Division of Infectious Diseases and Infection Prevention, City Hospital Zurich, Birmensdorferstrasse 497, 8063, Zurich, SwitzerlandDepartment of Internal Medicine, Division of Infectious Diseases and Infection Prevention, City Hospital Zurich, Birmensdorferstrasse 497, 8063, Zurich, SwitzerlandDepartment of Internal Medicine, Division of Pulmonology, City Hospital Zurich, Birmensdorferstrasse 497, 8063, Zurich, SwitzerlandDepartment of Internal Medicine, Clinic for Internal Medicine, City Hospital Zurich, Birmensdorferstrasse 497, 8063, Zurich, SwitzerlandDepartment of Internal Medicine, Clinic for Internal Medicine, City Hospital Zurich, Birmensdorferstrasse 497, 8063, Zurich, Switzerland; Corresponding author.Background: Immune-reconstitution inflammatory syndrome (IRIS) is a dysregulated host inflammatory response following the initiation of appropriate therapy targeting an infectious disease. It is most commonly reported in human immunodeficiency virus patients following the initiation of antiretroviral therapy; however, IRIS can also be seen in immunocompromised patients without HIV, when the immune system is recovering. The diagnosis is confirmed using clinical and laboratory data after excluding differential diagnoses and concomitant infections. Case series: Here, we describe three cases of patients with IRIS that were treated at our tertiary care center. The first case involves a paradoxical IRIS in an HIV-positive patient with TB, where the re-initiation of ART led to an inflammatory response despite effective anti-tuberculous treatment (ATT). The second case highlights unmasking IRIS in an HIV-positive patient, where the initiation of ART revealed an underlying Epstein-Barr virus (EBV)-associated B-cell lymphoma. The third case describes paradoxical worsening of pulmonary TB in an HIV-negative patient, expanding the scope of IRIS beyond its conventional association with HIV infection. Conclusion: These cases illustrate the various manifestations of IRIS and emphasize the need for timely diagnosis and appropriate management strategies to mitigate the potentially severe outcomes associated with this syndrome. Our report highlights the challenges faced in the diagnosis of IRIS which impede prompt onset of therapy.http://www.sciencedirect.com/science/article/pii/S2213007125000498Immune reconstitution inflammatory syndromeIRISTuberculosisTBHIVLymphoma |
| spellingShingle | Sebastian Schregenberger Vera Graup Adrian Schibli Benjamin Preiswerk Irène Laube Lars C. Huber Melina Stüssi-Helbling Immune reconstitution inflammatory syndrome (IRIS): Case series and review of the literature Respiratory Medicine Case Reports Immune reconstitution inflammatory syndrome IRIS Tuberculosis TB HIV Lymphoma |
| title | Immune reconstitution inflammatory syndrome (IRIS): Case series and review of the literature |
| title_full | Immune reconstitution inflammatory syndrome (IRIS): Case series and review of the literature |
| title_fullStr | Immune reconstitution inflammatory syndrome (IRIS): Case series and review of the literature |
| title_full_unstemmed | Immune reconstitution inflammatory syndrome (IRIS): Case series and review of the literature |
| title_short | Immune reconstitution inflammatory syndrome (IRIS): Case series and review of the literature |
| title_sort | immune reconstitution inflammatory syndrome iris case series and review of the literature |
| topic | Immune reconstitution inflammatory syndrome IRIS Tuberculosis TB HIV Lymphoma |
| url | http://www.sciencedirect.com/science/article/pii/S2213007125000498 |
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