Immunological Reconstitution Inflammatory Syndrome and Thrombotic Microangiopathy: Severe Complications in a Child With Acquired Immunodeficiency Syndrome

Rocha, AP; Milheiro Silva, T; Francisco, T; Neves, C; Brites, V; Candeias, F

http://hdl.handle.net/10400.17/3466

Use this identifier to reference this record.

Name:	Description:	Size:	Format:
Clin Pediatr 2019_58_1022.pdf		104.92 KB	Adobe PDF	Download

Send Feedback

Authors

Abstract(s)

Some patients with human immunodeficiency virus (HIV) infection deteriorate shortly after starting highly active antiretroviral therapy (HAART), the so-called immunological reconstitution inflammatory syndrome (IRIS).1 Although having a spontaneous resolution in many instances, it can be fatal.1 Worse prognosis is seen in younger children, severe immunosuppression and central nervous system IRIS, or infections with specific agents, namely, Criptococcus.2 Hemophagocytic lymphohistiocytosis (HLH) has also been described in children with HIV infection, in the context of an immunological system dysregulation.3 Thrombotic microangiopathy (TMA) became rare with the introduction of HAART, being mostly associated with advanced disease.4 HIV-associated TMA has specific clinical aspects as well as a worse prognosis than idiopathic or congenital TMA.4-9 The authors present the case of a 10-month-old boy with advanced HIV infection who developed IRIS complicated with HLH and TMA during the course of his treatment.

Keywords

Acquired Immunodeficiency Syndrome Anti-Bacterial Agents Antiretroviral Therapy, Highly Active Diagnosis, Differential Fatal Outcome Humans Immune Reconstitution Inflammatory Syndrome Immunoglobulins Infant Lymphohistiocytosis, Hemophagocytic Male Methylprednisolone Thrombotic Microangiopathies HDE PED