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Dramatic improvement of severe cryptococcosis-induced immune reconstitution syndrome with adalimumab in a renal transplant recipient.
Am J Transplant. 2015 Feb; 15(2):560-4.AJ

Abstract

In solid organ transplant recipients, immune reconstitution inflammatory syndrome (IRIS) is a rare complication of cryptococcosis, which may require steroids in its most severe forms. Here, we report the case of a renal transplant recipient who developed severe cryptococcal meningitis-associated IRIS 1 week after immunosuppression reduction. High-dose steroids failed to improve the disease. Finally, a recombinant human monoclonal tumor necrosis factor-α (TNF-α) antagonist, adalimumab, was prescribed, and the patient rapidly experienced dramatic neurological improvement. No IRIS relapse occurred within 14 months following adalimumab discontinuation.

Authors+Show Affiliations

Service de Néphrologie et Transplantation Adulte, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, RTRS Centaure, Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

25611999

Citation

Scemla, A, et al. "Dramatic Improvement of Severe Cryptococcosis-induced Immune Reconstitution Syndrome With Adalimumab in a Renal Transplant Recipient." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol. 15, no. 2, 2015, pp. 560-4.
Scemla A, Gerber S, Duquesne A, et al. Dramatic improvement of severe cryptococcosis-induced immune reconstitution syndrome with adalimumab in a renal transplant recipient. Am J Transplant. 2015;15(2):560-4.
Scemla, A., Gerber, S., Duquesne, A., Parize, P., Martinez, F., Anglicheau, D., Snanoudj, R., Zuber, M., Bougnoux, M. E., Legendre, C., & Lortholary, O. (2015). Dramatic improvement of severe cryptococcosis-induced immune reconstitution syndrome with adalimumab in a renal transplant recipient. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 15(2), 560-4. https://doi.org/10.1111/ajt.13002
Scemla A, et al. Dramatic Improvement of Severe Cryptococcosis-induced Immune Reconstitution Syndrome With Adalimumab in a Renal Transplant Recipient. Am J Transplant. 2015;15(2):560-4. PubMed PMID: 25611999.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dramatic improvement of severe cryptococcosis-induced immune reconstitution syndrome with adalimumab in a renal transplant recipient. AU - Scemla,A, AU - Gerber,S, AU - Duquesne,A, AU - Parize,P, AU - Martinez,F, AU - Anglicheau,D, AU - Snanoudj,R, AU - Zuber,M, AU - Bougnoux,M-E, AU - Legendre,C, AU - Lortholary,O, Y1 - 2015/01/21/ PY - 2014/04/15/received PY - 2014/08/07/revised PY - 2014/08/23/accepted PY - 2015/1/23/entrez PY - 2015/1/23/pubmed PY - 2015/10/2/medline KW - antibiotic: antifungal, infection and infectious agents KW - clinical research/practice KW - fungal KW - immunosuppressant KW - infectious disease KW - kidney transplantation/nephrology KW - other SP - 560 EP - 4 JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons JO - Am. J. Transplant. VL - 15 IS - 2 N2 - In solid organ transplant recipients, immune reconstitution inflammatory syndrome (IRIS) is a rare complication of cryptococcosis, which may require steroids in its most severe forms. Here, we report the case of a renal transplant recipient who developed severe cryptococcal meningitis-associated IRIS 1 week after immunosuppression reduction. High-dose steroids failed to improve the disease. Finally, a recombinant human monoclonal tumor necrosis factor-α (TNF-α) antagonist, adalimumab, was prescribed, and the patient rapidly experienced dramatic neurological improvement. No IRIS relapse occurred within 14 months following adalimumab discontinuation. SN - 1600-6143 UR - https://www.unboundmedicine.com/medline/citation/25611999/Dramatic_Improvement_of_Severe_Cryptococcosis_Induced_Immune_Reconstitution_Syndrome_With_Adalimumab_in_a_Renal_Transplant_Recipient_ L2 - https://doi.org/10.1111/ajt.13002 DB - PRIME DP - Unbound Medicine ER -