AIDS-related Mycobacterium avium infection dissemination in a patient with endobronchial lesions associated with immune reconstitution inflammatory syndrome

Eiichi Ogawa, Murata Masayuki, Hachirou Ohnishi, Masafumi Tatsukawa, Yasunori Sawayama, Norihiro Furusyo, Jun Hayashi

Research output: Contribution to journalArticle

Abstract

Highly active antiretroviral therapy (HAART) has dramatically decreased the incidence of HIV-1-associated morbidity and mortality. During the initial months of HAART, immune reconstitution inflammatory syndrome (IRIS), an adverse consequence of restoration of the pathogen-specific immune response, often occurred in terminal-stage in patients, with MAC infection the most frequently implicated in IRIS. In August 2004, a 26-year-old Japanese woman with fever and general lymphadenopathy was diagnosed with AIDS (HIV-1 RNA 5.7 x 10(5) copies/mL, CD4+ T cell count 10/microL) and disseminated Mycobacterium avium (M. avium) infection, for which antimycobacterial treatment was initiated. The M. avium infection responded well to two months of this treatment, and HAART was begun. Despite good virologic response to HAART (HIV-1 RNA <50 copies/mL), she contracted pulmonary disease with parenchymal lung changes, endobronchial lesions, and localized supraclavicular lymphadenitis, which are M. avium-associated IRIS. Good immunological response (CD4+ T cell count 136/microL) and a stronger antimycobacterial treatment helped her overcoming M. avium-associated IRIS without systemic corticosteroids or the discontinuation of HAART. The possibility of IRIS should always be watched for when treating AIDS patients with HAART and an antimycobacterial treatment regimen formulated that considers potential drug interactions with HAART.

Original languageEnglish
Pages (from-to)341-346
Number of pages6
JournalKansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases
Volume82
Issue number4
DOIs
Publication statusPublished - Jan 1 2008

Fingerprint

Immune Reconstitution Inflammatory Syndrome
Mycobacterium avium
Mycobacterium Infections
Highly Active Antiretroviral Therapy
Acquired Immunodeficiency Syndrome
HIV-1
CD4 Lymphocyte Count
RNA
T-Lymphocytes
Lymphadenitis
Therapeutics
Drug Interactions
Lung Diseases
Adrenal Cortex Hormones
Fever
Morbidity
Lung
Mortality
Incidence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

AIDS-related Mycobacterium avium infection dissemination in a patient with endobronchial lesions associated with immune reconstitution inflammatory syndrome. / Ogawa, Eiichi; Masayuki, Murata; Ohnishi, Hachirou; Tatsukawa, Masafumi; Sawayama, Yasunori; Furusyo, Norihiro; Hayashi, Jun.

In: Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, Vol. 82, No. 4, 01.01.2008, p. 341-346.

Research output: Contribution to journalArticle

@article{0f970bc588dc490b970db8e7cd616b14,
title = "AIDS-related Mycobacterium avium infection dissemination in a patient with endobronchial lesions associated with immune reconstitution inflammatory syndrome",
abstract = "Highly active antiretroviral therapy (HAART) has dramatically decreased the incidence of HIV-1-associated morbidity and mortality. During the initial months of HAART, immune reconstitution inflammatory syndrome (IRIS), an adverse consequence of restoration of the pathogen-specific immune response, often occurred in terminal-stage in patients, with MAC infection the most frequently implicated in IRIS. In August 2004, a 26-year-old Japanese woman with fever and general lymphadenopathy was diagnosed with AIDS (HIV-1 RNA 5.7 x 10(5) copies/mL, CD4+ T cell count 10/microL) and disseminated Mycobacterium avium (M. avium) infection, for which antimycobacterial treatment was initiated. The M. avium infection responded well to two months of this treatment, and HAART was begun. Despite good virologic response to HAART (HIV-1 RNA <50 copies/mL), she contracted pulmonary disease with parenchymal lung changes, endobronchial lesions, and localized supraclavicular lymphadenitis, which are M. avium-associated IRIS. Good immunological response (CD4+ T cell count 136/microL) and a stronger antimycobacterial treatment helped her overcoming M. avium-associated IRIS without systemic corticosteroids or the discontinuation of HAART. The possibility of IRIS should always be watched for when treating AIDS patients with HAART and an antimycobacterial treatment regimen formulated that considers potential drug interactions with HAART.",
author = "Eiichi Ogawa and Murata Masayuki and Hachirou Ohnishi and Masafumi Tatsukawa and Yasunori Sawayama and Norihiro Furusyo and Jun Hayashi",
year = "2008",
month = "1",
day = "1",
doi = "10.11150/kansenshogakuzasshi1970.82.341",
language = "English",
volume = "82",
pages = "341--346",
journal = "Nippon Densenbyo Gakkai zasshi",
issn = "0387-5911",
publisher = "Nihon Kansensho Gakkai",
number = "4",

}

TY - JOUR

T1 - AIDS-related Mycobacterium avium infection dissemination in a patient with endobronchial lesions associated with immune reconstitution inflammatory syndrome

AU - Ogawa, Eiichi

AU - Masayuki, Murata

AU - Ohnishi, Hachirou

AU - Tatsukawa, Masafumi

AU - Sawayama, Yasunori

AU - Furusyo, Norihiro

AU - Hayashi, Jun

PY - 2008/1/1

Y1 - 2008/1/1

N2 - Highly active antiretroviral therapy (HAART) has dramatically decreased the incidence of HIV-1-associated morbidity and mortality. During the initial months of HAART, immune reconstitution inflammatory syndrome (IRIS), an adverse consequence of restoration of the pathogen-specific immune response, often occurred in terminal-stage in patients, with MAC infection the most frequently implicated in IRIS. In August 2004, a 26-year-old Japanese woman with fever and general lymphadenopathy was diagnosed with AIDS (HIV-1 RNA 5.7 x 10(5) copies/mL, CD4+ T cell count 10/microL) and disseminated Mycobacterium avium (M. avium) infection, for which antimycobacterial treatment was initiated. The M. avium infection responded well to two months of this treatment, and HAART was begun. Despite good virologic response to HAART (HIV-1 RNA <50 copies/mL), she contracted pulmonary disease with parenchymal lung changes, endobronchial lesions, and localized supraclavicular lymphadenitis, which are M. avium-associated IRIS. Good immunological response (CD4+ T cell count 136/microL) and a stronger antimycobacterial treatment helped her overcoming M. avium-associated IRIS without systemic corticosteroids or the discontinuation of HAART. The possibility of IRIS should always be watched for when treating AIDS patients with HAART and an antimycobacterial treatment regimen formulated that considers potential drug interactions with HAART.

AB - Highly active antiretroviral therapy (HAART) has dramatically decreased the incidence of HIV-1-associated morbidity and mortality. During the initial months of HAART, immune reconstitution inflammatory syndrome (IRIS), an adverse consequence of restoration of the pathogen-specific immune response, often occurred in terminal-stage in patients, with MAC infection the most frequently implicated in IRIS. In August 2004, a 26-year-old Japanese woman with fever and general lymphadenopathy was diagnosed with AIDS (HIV-1 RNA 5.7 x 10(5) copies/mL, CD4+ T cell count 10/microL) and disseminated Mycobacterium avium (M. avium) infection, for which antimycobacterial treatment was initiated. The M. avium infection responded well to two months of this treatment, and HAART was begun. Despite good virologic response to HAART (HIV-1 RNA <50 copies/mL), she contracted pulmonary disease with parenchymal lung changes, endobronchial lesions, and localized supraclavicular lymphadenitis, which are M. avium-associated IRIS. Good immunological response (CD4+ T cell count 136/microL) and a stronger antimycobacterial treatment helped her overcoming M. avium-associated IRIS without systemic corticosteroids or the discontinuation of HAART. The possibility of IRIS should always be watched for when treating AIDS patients with HAART and an antimycobacterial treatment regimen formulated that considers potential drug interactions with HAART.

UR - http://www.scopus.com/inward/record.url?scp=53049110313&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=53049110313&partnerID=8YFLogxK

U2 - 10.11150/kansenshogakuzasshi1970.82.341

DO - 10.11150/kansenshogakuzasshi1970.82.341

M3 - Article

C2 - 18697487

AN - SCOPUS:53049110313

VL - 82

SP - 341

EP - 346

JO - Nippon Densenbyo Gakkai zasshi

JF - Nippon Densenbyo Gakkai zasshi

SN - 0387-5911

IS - 4

ER -