Aspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survival
Abstract Aspergillus-related immune reconstitution inflammatory syndrome (IRIS) is a challenge to diagnose in immunocompromised pediatric cancer patients with Invasive Pulmonary Aspergillosis (IPA). If not recognized, it can mimic disease progression and lead to overtreatment. Studies on Aspergillus...
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BMC
2024-12-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-024-10298-z |
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| author | Ali Amanati Mehdi Ghaderian Jahromi Hadis Jafarian Seyed Reza Abdipour Mehrian Sarvin Sajedianfard Shahdad Farokhmanesh Arman Maddahi Farima Safari Seyed Ali Nabavizadeh Mohammad Matin Karbalaee Alinazari |
| author_facet | Ali Amanati Mehdi Ghaderian Jahromi Hadis Jafarian Seyed Reza Abdipour Mehrian Sarvin Sajedianfard Shahdad Farokhmanesh Arman Maddahi Farima Safari Seyed Ali Nabavizadeh Mohammad Matin Karbalaee Alinazari |
| author_sort | Ali Amanati |
| collection | DOAJ |
| description | Abstract Aspergillus-related immune reconstitution inflammatory syndrome (IRIS) is a challenge to diagnose in immunocompromised pediatric cancer patients with Invasive Pulmonary Aspergillosis (IPA). If not recognized, it can mimic disease progression and lead to overtreatment. Studies on Aspergillus-related IRIS in the pediatric population are scarce. We prospectively identified four pediatric cancer patients diagnosed with IPA who developed paradoxical worsening of pulmonary symptoms following neutrophil recovery. The clinical course, imaging findings, and response to corticosteroids were also reviewed. All patients had refractory respiratory symptoms, including cough, breathing difficulties (dyspnea), and chest pain, despite antifungal therapy. Serial imaging revealed new or enlarging pulmonary infiltrates. Symptoms improved dramatically with corticosteroids without antifungal escalation, confirming Aspergillus-related IRIS diagnosis. Aspergillus-related IRIS can occur in immunocompromised children with cancer and IPA, mimicking disease progression. Recognition is important for avoiding overtreatment. This is the first report highlighting the features of Aspergillus-related IRIS in pediatric cancer patients. |
| format | Article |
| id | doaj-art-ec9ceaa7457e478dbd4872ea203a0784 |
| institution | OA Journals |
| issn | 1471-2334 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-ec9ceaa7457e478dbd4872ea203a07842025-08-20T02:31:38ZengBMCBMC Infectious Diseases1471-23342024-12-0124111310.1186/s12879-024-10298-zAspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survivalAli Amanati0Mehdi Ghaderian Jahromi1Hadis Jafarian2Seyed Reza Abdipour Mehrian3Sarvin Sajedianfard4Shahdad Farokhmanesh5Arman Maddahi6Farima Safari7Seyed Ali Nabavizadeh8Mohammad Matin Karbalaee Alinazari9Shiraz University of Medical SciencesDepartment of Radiology, Medical Imaging Research Center, Shiraz University of Medical SciencesAlborzi Clinical Microbiology Research Center, Shiraz University of Medical SciencesHealth Policy Research Center, Institute of Health, Shiraz University of Medical SciencesShiraz University of Medical SciencesAlborzi Clinical Microbiology Research Center, Shiraz University of Medical SciencesAlborzi Clinical Microbiology Research Center, Shiraz University of Medical SciencesHealth Policy Research Center, Institute of Health, Shiraz University of Medical SciencesStudent Research Committee, School of Medicine, Shiraz University of Medical SciencesStudent Research Committee, School of Medicine, Shiraz University of Medical SciencesAbstract Aspergillus-related immune reconstitution inflammatory syndrome (IRIS) is a challenge to diagnose in immunocompromised pediatric cancer patients with Invasive Pulmonary Aspergillosis (IPA). If not recognized, it can mimic disease progression and lead to overtreatment. Studies on Aspergillus-related IRIS in the pediatric population are scarce. We prospectively identified four pediatric cancer patients diagnosed with IPA who developed paradoxical worsening of pulmonary symptoms following neutrophil recovery. The clinical course, imaging findings, and response to corticosteroids were also reviewed. All patients had refractory respiratory symptoms, including cough, breathing difficulties (dyspnea), and chest pain, despite antifungal therapy. Serial imaging revealed new or enlarging pulmonary infiltrates. Symptoms improved dramatically with corticosteroids without antifungal escalation, confirming Aspergillus-related IRIS diagnosis. Aspergillus-related IRIS can occur in immunocompromised children with cancer and IPA, mimicking disease progression. Recognition is important for avoiding overtreatment. This is the first report highlighting the features of Aspergillus-related IRIS in pediatric cancer patients.https://doi.org/10.1186/s12879-024-10298-zImmune reconstitution inflammatory syndromePediatric cancer patientsInvasive pulmonary aspergillosis |
| spellingShingle | Ali Amanati Mehdi Ghaderian Jahromi Hadis Jafarian Seyed Reza Abdipour Mehrian Sarvin Sajedianfard Shahdad Farokhmanesh Arman Maddahi Farima Safari Seyed Ali Nabavizadeh Mohammad Matin Karbalaee Alinazari Aspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survival BMC Infectious Diseases Immune reconstitution inflammatory syndrome Pediatric cancer patients Invasive pulmonary aspergillosis |
| title | Aspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survival |
| title_full | Aspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survival |
| title_fullStr | Aspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survival |
| title_full_unstemmed | Aspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survival |
| title_short | Aspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survival |
| title_sort | aspergillus related immune reconstitution inflammatory syndrome in pediatric cancer patients clinical characteristics imaging findings and survival |
| topic | Immune reconstitution inflammatory syndrome Pediatric cancer patients Invasive pulmonary aspergillosis |
| url | https://doi.org/10.1186/s12879-024-10298-z |
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