Fujita Jiro
Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, 903-0215, Japan.
Respir Investig. 2020 Jan;58(1):36-44. doi: 10.1016/j.resinv.2019.11.001. Epub 2019 Nov 29.
We evaluated immune reconstitution inflammatory syndrome (IRIS) in the lung in non-human immunodeficiency virus (HIV) patients.
We reviewed articles related to IRIS occurrence in the lung in non-HIV patients using a PubMed search. The keywords used for the search were "immune reconstitution syndrome" and "non-HIV." Only patients with lung involvement were included. Those with suggested IRIS caused by white blood cell recovery were excluded.
There were 37 cases of IRIS in the lung in non-HIV patients. Complicating infections included tuberculosis (n = 17), histoplasmosis (n = 9), aspergillosis (n = 5), cryptococcosis (n = 4), and Pneumocystis pneumonia (n = 2). We also evaluated the underlying diseases, IRIS pathogenesis, management, and prognosis. IRIS was most commonly encountered in patients treated with anti-tumor necrosis factor (TNF) antibody who developed disseminated or extrapulmonary tuberculosis, leading to treatment discontinuation.
The diagnosis and management of IRIS in the lung in non-HIV patients should be investigated further, especially in the era of anti-TNF treatment.
我们评估了非人类免疫缺陷病毒（HIV）患者肺部的免疫重建炎症综合征（IRIS）。
我们使用PubMed搜索回顾了与非HIV患者肺部IRIS发生相关的文章。搜索所用关键词为“免疫重建综合征”和“非HIV”。仅纳入有肺部受累的患者。排除由白细胞恢复引起的疑似IRIS患者。
非HIV患者中有37例肺部IRIS病例。并发感染包括结核病（n = 17）、组织胞浆菌病（n = 9）、曲霉病（n = 5）、隐球菌病（n = 4）和肺孢子菌肺炎（n = 2）。我们还评估了基础疾病、IRIS发病机制、治疗及预后。IRIS最常见于接受抗肿瘤坏死因子（TNF）抗体治疗且发生播散性或肺外结核病的患者，这导致了治疗中断。
应进一步研究非HIV患者肺部IRIS的诊断和治疗，尤其是在抗TNF治疗时代。
