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Am J Transplant. 2015 Feb;15(2):560-4. doi: 10.1111/ajt.13002. Epub 2015 Jan 21.

Dramatic improvement of severe cryptococcosis-induced immune reconstitution syndrome with adalimumab in a renal transplant recipient.

Author information

1
Service de Néphrologie et Transplantation Adulte, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, RTRS Centaure, Paris, France.

Abstract

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.

KEYWORDS:

antibiotic: antifungal, infection and infectious agents; clinical research/practice; fungal; immunosuppressant; infectious disease; kidney transplantation/nephrology; other

PMID:
25611999
DOI:
10.1111/ajt.13002
[Indexed for MEDLINE]
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