Dramatic Improvement of Severe Cryptococcosis-Induced Immune Reconstitution Syndrome With Adalimumab in a Renal Transplant Recipient.

AJT Dramatic Improvement of Severe Cryptococcosis-Induced Immune Reconstitution Syndrome With Adalimumab in a Renal Transplant Recipient.

• Scemla A, Gerber S, Duquesne A, et al. 
• Dramatic Improvement of Severe Cryptococcosis-Induced Immune Reconstitution Syndrome With Adalimumab in a Renal Transplant Recipient. [JOURNAL ARTICLE]
• Am J Transplant 2015 Jan 21.

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.

http://www.unboundmedicine.com/medline/citation/25611999/Dramatic_Improvement_of_Severe_Cryptococcosis_Induced_Immune_Reconstitution_Syndrome_With_Adalimumab_in_a_Renal_Transplant_Recipient_

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Alberto Reino Buelvas 

Médico Internista Nefrólogo