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中枢神经系统-免疫重建炎症综合征在 HIV 感染中的表现,第 2 部分:讨论伴有和不伴有其他病原体的神经免疫重建炎症综合征。

CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 2: discussion of neuro-immune reconstitution inflammatory syndrome with and without other pathogens.

机构信息

Section of Neuroradiology, Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Medical Center, Miami, FL 33136, USA.

出版信息

AJNR Am J Neuroradiol. 2013 Jul;34(7):1308-18. doi: 10.3174/ajnr.A3184. Epub 2012 Jul 12.

DOI:10.3174/ajnr.A3184
PMID:22790252
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4905746/
Abstract

While the previous review of CNS-IRIS in the HIV-infected patient on highly active antiretroviral therapy (Part 1) dealt with an overview of the biology, pathology, and neurologic presentation of this condition and a discussion of the atypical imaging findings in PML-IRIS and cryptococcal meningitis-IRIS due to the robust inflammatory response, the current review (Part 2) discusses the imaging findings in other commonly encountered organisms seen in association with CNS-IRIS, namely, VZV, CMV, HIV, Candida organisms, Mycobacterium tuberculosis, and Toxoplasma gondii. Also described is the imaging appearance of CNS-IRIS when not associated with a particular organism. Recognition of these imaging findings will give credence to the diagnosis of CNS-IRIS and will allow the clinician to institute changes in medical management, if necessary, so that immune reconstitution and improved patient outcome can occur with time.

摘要

在上一篇关于 HIV 感染者接受高效抗逆转录病毒治疗(第 1 部分)时中枢神经系统(CNS)免疫重建炎症综合征(IRIS)的综述中,我们讨论了该疾病的生物学、病理学和神经表现,并讨论了由于强烈炎症反应引起的朊病毒病(PML)IRIS 和隐球菌性脑膜炎(CM)IRIS 的非典型影像学表现,而本篇综述(第 2 部分)讨论了与 CNS-IRIS 相关的其他常见病原体(如单纯疱疹病毒(VZV)、巨细胞病毒(CMV)、HIV、念珠菌、结核分枝杆菌和刚地弓形虫)的影像学表现。同时还描述了与特定病原体无关的 CNS-IRIS 的影像学表现。识别这些影像学表现将有助于 CNS-IRIS 的诊断,并使临床医生能够在必要时调整医疗管理,如果随着时间的推移能够实现免疫重建和改善患者预后。