Immune reconstitution inflammatory syndrome - Revision history

ClaireLewis at 01:17, 2 October 2019

2019-10-02T01:17:21Z

← Revisión anterior		Revisión del 01:17 2 oct 2019
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	===Major Presentations===		===Major Presentations===
	*[[TB]]- worsening TB symptoms		*[[TB]]- worsening TB symptoms
	*MAC- localized lymphadenitis, pulmonary disease, systemic inflammation indistinguishable from active MAC		*[[mycobacterium avium\|MAC]]- localized [[lymphadenitis]], pulmonary disease, systemic inflammation indistinguishable from active MAC
	**MAC-IRIS patients are not bacteremic		**MAC-IRIS patients are not bacteremic
	*[[Cryptococcosis]]- worsening meningitis symptoms		*[[Cryptococcosis]]- worsening meningitis symptoms
	*[[CMV]]-~~Retinitis~~, ~~Vitritis~~, ~~Uveitis~~		*[[CMV]]- [[CMV retinitis\|retinitis]], vitritis, [[uveitis]]
	**IRIS due to CMV can cause vision loss		**IRIS due to CMV can cause vision loss
	***mean time to vitritis 20 weeks		***mean time to vitritis 20 weeks
	*[[Hepatitis]] B or C- transient transaminitis difficult to distinguish from drug induced cause		*[[viral hepatitis\|Hepatitis]] B or C- transient transaminitis difficult to distinguish from drug induced cause
	**hepatic flares usually mild, may decompensate cirrhotics.		**hepatic flares usually mild, may decompensate cirrhotics.
	*[[Progressive multifocal leukoencephalopathy]]- worsening focal neuro lesions, changes on MRI		*[[Progressive multifocal leukoencephalopathy]]- worsening focal neuro lesions, changes on [[brain MRI\|MRI]]
	*[[Kaposi's Sarcoma]]- worsening Kaposi's		*[[Kaposi's Sarcoma]]- worsening Kaposi's
	*Autoimmune diseases- Pre-existing autoimmune disorder exacerbation		*Autoimmune diseases- Pre-existing autoimmune disorder exacerbation
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	==Differential Diagnosis==		==Differential Diagnosis==
	*New infection not associated with IRIS (i.e. bacterial meningitis)		*New infection not associated with IRIS (i.e. bacterial [[meningitis]])
	*Opportunistic ~~Infection~~		*Opportunistic [[infection]]

	{{HIV associated conditions}}		{{HIV associated conditions}}
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	==Evaluation==		==Evaluation==
	*Index of suspicion with known recent initiation of ARV's		*Index of suspicion with known recent initiation of ARV's
	*System specific testing (CXR, LP etc)		*System specific testing ([[CXR]], [[LP]] etc)

	==Management==		==Management==
	===Mild IRIS===		===Mild IRIS===
	*Standard therapy for offending opportunistic info (i.e. acyclovir for HSV)		*Standard therapy for offending opportunistic info (i.e. [[acyclovir]] for HSV)
	*Largely supportive care		*Largely supportive care
	**~~NSAID's~~ for mild symptoms		**[[NSAIDs]] for mild symptoms
	**Inhaled steroids for pulmonary symptoms		**[[Inhaled steroids]] for pulmonary symptoms
	*Continue ARV except in severe IRIS (see below)		*Continue ARV except in severe IRIS (see below)

Mholtz at 02:55, 10 May 2017

2017-05-10T02:55:11Z

← Revisión anterior		Revisión del 02:55 10 may 2017
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	==Disposition==		==Disposition==
	*Admit for severe IRIS.		*Admit for severe IRIS.
	*Dispo in conjunction with HIV/ID.		*Dispo in conjunction with HIV/ID consult.

	==See Also==		==See Also==
	*[[HIV - AIDS (Main)]]		*[[HIV - AIDS (Main)]]
	*[[HIV diarrhea]]		*[[HIV diarrhea]]

			==External Links==
			*www.hivguidelines.org

	==References==		==References==
	<references/>		<references/>
	*<nowiki>www.hivguidelines.org </nowiki>

	[[Category:ID]]		[[Category:ID]]

ClaireLewis: /* Major Presentations */

2016-11-13T22:41:40Z

Major Presentations

← Revisión anterior		Revisión del 22:41 13 nov 2016
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	*[[Hepatitis]] B or C- transient transaminitis difficult to distinguish from drug induced cause		*[[Hepatitis]] B or C- transient transaminitis difficult to distinguish from drug induced cause
	**hepatic flares usually mild, may decompensate cirrhotics.		**hepatic flares usually mild, may decompensate cirrhotics.
	*[[Progressive ~~Multifocal Leukoencephalopathy~~]]- worsening focal neuro lesions, changes on MRI		*[[Progressive multifocal leukoencephalopathy]]- worsening focal neuro lesions, changes on MRI
	*[[Kaposi's Sarcoma]]- worsening Kaposi's		*[[Kaposi's Sarcoma]]- worsening Kaposi's
	*Autoimmune diseases- Pre-existing autoimmune disorder exacerbation		*Autoimmune diseases- Pre-existing autoimmune disorder exacerbation

ClaireLewis: /* Major Presentations */

2016-11-13T22:41:17Z

Major Presentations

← Revisión anterior		Revisión del 22:41 13 nov 2016
Línea 17:		Línea 17:
	*[[Hepatitis]] B or C- transient transaminitis difficult to distinguish from drug induced cause		*[[Hepatitis]] B or C- transient transaminitis difficult to distinguish from drug induced cause
	**hepatic flares usually mild, may decompensate cirrhotics.		**hepatic flares usually mild, may decompensate cirrhotics.
	*Progressive Multifocal Leukoencephalopathy- worsening focal neuro lesions, changes on MRI		*[[Progressive Multifocal Leukoencephalopathy]]- worsening focal neuro lesions, changes on MRI
	*[[Kaposi's Sarcoma]]- worsening Kaposi's		*[[Kaposi's Sarcoma]]- worsening Kaposi's
	*Autoimmune diseases- Pre-existing autoimmune disorder exacerbation		*Autoimmune diseases- Pre-existing autoimmune disorder exacerbation

ClaireLewis at 03:53, 5 October 2016

2016-10-05T03:53:40Z

← Revisión anterior		Revisión del 03:53 5 oct 2016
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	===Minor Presentations===		===Minor Presentations===
	*[[Herpes Simplex Virus]] and [[Varicella ~~Zoster Virus~~]] reactivation		*[[Herpes Simplex Virus]] and [[Varicella zoster virus]] reactivation
	*Non-specific derm- many including oral and genital warts		*Non-specific derm- many including oral and genital warts

Rossdonaldson1: Text replacement - " HIV " to " HIV "

2016-09-08T10:26:54Z

Text replacement - " HIV " to " HIV "

← Revisión anterior		Revisión del 10:26 8 sep 2016
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	==Background==		==Background==
	*Also called IRIS		*Also called IRIS
	*Definition-Disease or pathogen specific inflammatory response in HIV infected patients after initiation or re-initiation of ARV therapy or after change to more active ARV therapy.		*Definition-Disease or pathogen specific inflammatory response in [[HIV]] infected patients after initiation or re-initiation of ARV therapy or after change to more active ARV therapy.
	*Usually low CD4 counts and high viral loads at time of ARV initiation		*Usually low CD4 counts and high viral loads at time of ARV initiation
	*Can occur at any CD4 count		*Can occur at any CD4 count

Rossdonaldson1: Text replacement - "pulm " to "pulmonary "

2016-07-30T23:44:13Z

Text replacement - "pulm " to "pulmonary "

← Revisión anterior		Revisión del 23:44 30 jul 2016
Línea 9:		Línea 9:
	===Major Presentations===		===Major Presentations===
	*[[TB]]- worsening TB symptoms		*[[TB]]- worsening TB symptoms
	*MAC- localized lymphadenitis, ~~pulm~~ disease, systemic inflammation indistinguishable from active MAC		*MAC- localized lymphadenitis, pulmonary disease, systemic inflammation indistinguishable from active MAC
	**MAC-IRIS patients are not bacteremic		**MAC-IRIS patients are not bacteremic
	*[[Cryptococcosis]]- worsening meningitis symptoms		*[[Cryptococcosis]]- worsening meningitis symptoms

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T03:06:52Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 03:06 22 jul 2016
Línea 31:		Línea 31:
	{{HIV associated conditions}}		{{HIV associated conditions}}

	==~~Diagnosis~~==		==Evaluation==
	*Index of suspicion with known recent initiation of ARV's		*Index of suspicion with known recent initiation of ARV's
	*System specific testing (CXR, LP etc)		*System specific testing (CXR, LP etc)

Zipdoc at 06:56, 4 August 2015

2015-08-04T06:56:55Z

← Revisión anterior		Revisión del 06:56 4 ago 2015
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	<references/>		<references/>
	*<nowiki>www.hivguidelines.org </nowiki>		*<nowiki>www.hivguidelines.org </nowiki>

			[[Category:ID]]

Rossdonaldson1: /* See Also */

2015-08-01T10:41:12Z

← Revisión anterior		Revisión del 10:41 1 ago 2015
Línea 52:		Línea 52:

	==See Also==		==See Also==
	*[[HIV (CD4)]]
	*[[HIV (Disposition)]]
	*[[HIV (Overview)]]
	*[[HIV - AIDS (Main)]]		*[[HIV - AIDS (Main)]]
	*[[HIV diarrhea]]		*[[HIV diarrhea]]