Immune reconstitution inflammatory syndrome in tuberculous pleurisy and ulcerative colitis: a case report

  • Federico Piffer Pulmonology Department, APSS Trento, Hospital of Arco, Italy.
  • Guido Levi | guido.levi@yahoo.it Pulmonology Unit, Spedali Civili, Brescia, Italy.
  • Giampietro Marchetti Pulmonology Unit, Spedali Civili, Brescia, Italy.
  • Chiara Barbieri Pulmonology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.

Abstract

We present the case of a 46-year-old Caucasian male, affected by ulcerative colitis, who developed tuberculous pleurisy during immunosuppressive therapy; despite proper therapy, worsening of the radiological findings was observed. The case was discussed among an online group of Italian physicians and diagnosis of immune reconstitution inflammatory syndrome (IRIS) tuberculosis was established. Therapy was continued and full recovery was obtained. IRIS is a syndrome initially described during opportunistic infections in HIV infected after being placed in anti-retroviral therapy. It reveals itself through a wide variety of manifestations, including fever, lymphadenopathies, worsening of lung infiltrates, pleural or pericardial effusion, central nervous system involvement. Few data are available regarding the best therapeutic options. IRIS is an insidious and potentially serious complication of opportunistic infections in immunocompromised patients. The always wider diffusion of immunosuppressive therapies increases the number of patients at risk, therefore physicians need to be aware of the issue.

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Published
2019-09-10
Info
Issue
Section
Pneumology - Case Reports
Keywords:
Tuberculosis, IRIS, chest ultrasound, thoracoscopy, infliximab
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  • PDF: 410
How to Cite
Piffer, F., Levi, G., Marchetti, G., & Barbieri, C. (2019). Immune reconstitution inflammatory syndrome in tuberculous pleurisy and ulcerative colitis: a case report. Monaldi Archives for Chest Disease, 89(3). https://doi.org/10.4081/monaldi.2019.1103