| Recognition of immune reconstitution syndrome necessary for better management of patients with severe drug eruptions and those under immunosuppressive therapy. | |
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MedLine Citation:
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PMID: 20962568 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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The immune reconstitution syndrome (IRS) is an increasingly recognized disease concept and is observed with a broad-spectrum of immunosuppressive therapy-related opportunistic infectious diseases and severe drug eruptions complicated by viral reactivations. Clinical illness consistent with IRS includes tuberculosis, herpes zoster, herpes simples, cytomegalovirus infections and sarcoidosis: thus, the manifestations of this syndrome and diverse and depend on the tissue burden of the preexisting infectious agents during the immunosuppressive state, the nature of the immune system being restored, and underlying diseases of the hosts. Although IRS has originally been reported to occur in the setting of HIV infection, it has become clear that the development of IRS can also be in HIV-negative hosts receiving immunosuppressive agents, such as prednisolone and tumor necrosis factor α inhibitors, upon their reduction and withdrawal. Drug-induced hypersensitivity syndrome, a life-threatening multiorgan system reaction, is another manifestation of the newly observed IRS. Clinical recognition of the IRS is especially important in improving the outcome for diseases with an otherwise life-threatening progenosis. Clinicians should be aware of the implications of IRS and recognize that relieving the symptoms and signs of immune recovery by anti-inflammatory therapies needs to be balanced with anti-microbial therapies aiming at reducing the amplitude and duration of tissue burden of preexisting microbes. |
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Authors:
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Tetsuo Shiohara; Maiko Kurata; Yoshiko Mizukawa; Yoko Kano |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-25 |
Journal Detail:
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Title: Allergology international : official journal of the Japanese Society of Allergology Volume: 59 ISSN: 1440-1592 ISO Abbreviation: Allergol Int Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9616296 Medline TA: Allergol Int Country: Japan |
Other Details:
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Languages: eng Pagination: 333-43 Citation Subset: IM |
Affiliation:
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Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan. tpshio@ks.kyorin−u.ac.jp |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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