Immune reconstitution inflammatory syndrome following cryptosporidial cholangitis

AIDS Cholangiopathy Secondary to Cytomegalovirus as Possible Unmasking Immune Reconstitution Inflammatory Syndrome in Human Immunodeficiency Virus-Infected Individual: Case Report and Review of the Literature

We present the first case report of cytomegalovirus (CMV) cholangiopathy as possible immune reconstitution inflammatory syndrome (IRIS) in a human immunodeficiency virus (HIV)-infected individual, within two months of starting effective HAART. The patient presented with abdominal pain, nausea, vomiting, decreased appetite, and jaundice. The patient was diagnosed on ERCP as AIDS cholangiopathy, and biopsy of the ampulla showed acute inflammation with CMV inclusion bodies. The patient underwent sphincterotomy with CBD stenting and HAART continued without use of ganciclovir or valganciclovir. On follow-up, the patient achieved clinical and histopathological cure, which was demonstrated on repeat ampullary biopsy.

Pulmonary cryptosporidiosis and immune reconstitution inflammatory syndrome: a case report and review

Cryptosporidium rarely affects the lungs, and is not typically associated with the immune reconstitution inflammatory syndrome (IRIS). We describe the first published case of pulmonary IRIS following the initiation of antiretroviral therapy in a patient with AIDS and pulmonary cryptosporidiosis, and discuss its implications for HIV patient care.