Zapalny zespół rekonstrukcji immunologicznej (IRIS z ang. immune restoration inflammatory syndrome) w przebiegu zakażenia wirusem ludzkiego niedoboru odporności (HIV z ang. human immunodeficiency virus) objawia się paradoksalnym pogorszeniem wcześniej występujących, nieleczonych lub częściowo leczonych zakażeń oportunistycznych po włączeniu skutecznej terapii antyretrowirusowej. Taki stan jest szczególnie częsty u pacjentów z utajonymi, nieleczonymi dotychczas zakażeniami mikobakteryjnymi.
1. ZAPALNY ZESPÓŁ REKONSTRUKCJI IMMUNOLOGICZNEJ - EPIDEMIOLOGIA
Zapalny zespół rekonstrukcji immunologicznej może dotyczyć około 10-50% chorych (zakażonych wirusem HIV) w zależności od aktualnego stanu klinicznego. Obserwuje się go najczęściej u pacjentów z liczbą limfocytów T CD+ poniżej 50/mikrolitr, u których doszło do nagłego spadku poziomu RNA wirusa HIV po włączeniu terapii HAART (z ang. highly active antiretroviral therapy).
2. ZAPALNY ZESPÓŁ REKONSTRUKCJI IMMUNOLOGICZNEJ - OBJAWY KLINICZNE
Objawy tego zespołu mogą się pojawić w każdym momencie, od 2 tygodni do 2 lat po rozpoczęciu leczenia. Należy do nich zaliczyć:
- zlokalizowane powiększenie węzłów chłonnych,
- przedłużające się stany gorączkowe,
- obecność nacieków w płucach,
- podwyższenie ciśnienia śródczaszkowego,
- zapalenie naczyniówki,
- chorobę Gravesa.
Przebieg kliniczny może być przedłużony, a w ciężkich przypadkach śmiertelny.
3. ZAPALNY ZESPÓŁ REKONSTRUKCJI IMMUNOLOGICZNEJ - PATOGENEZA
Mechanizm leżący u podłoża omawianego zespołu wydaje się być związany ze zjawiskiem podobnym do reakcji nadwrażliwości typu IV. Jest on odzwierciedleniem natychmiastowej poprawy czynności układu immunologicznego, do której dochodzi po obniżeniu się poziomów RNA HIV i zniwelowaniu immunosupresyjnego wpływu zakażenia HIV. W ciężkich przypadkach konieczne jest włączenie leków immunosupresyjnych (jak np. glikokortykosteroidów) w celu stłumienia składowej zapalnej tego typu reakcji, przed uzyskaniem efektów swoistej terapii przeciwdrobnoustrojowej.
KATEGORIA: CHOROBY ZAKAŹNE, CHOROBY WEWNĘTRZNE, MIKROBIOLOGIA, IMMUNOLOGIA KLINICZNA
TAGI: Reconstitución inmune síndrome inflamatorio (IRIS destaca. Restauración inmune síndrome inflamatorio) en el curso de la infección con el virus de la inmunodeficiencia humana (VIH significa. Virus de la inmunodeficiencia humana) reveló un empeoramiento paradójico de la preexistente, sin tratar o parcialmente tratadas por infecciones oportunistas después de encender la terapia antirretroviral eficaz. Esta condición es particularmente común en los pacientes con infecciones latentes mikobakteryjnymi no tratados previamente. 1 INFLAMABLE RECONSTRUCCIÓN DEL EQUIPO DE INMUNE - EPIDEMIOLOGÍA síndrome de reconstitución inmune inflamatoria puede afectar aproximadamente el 10-50% de los pacientes (infectados con VIH) en función de la situación clínica actual. Se observa con mayor frecuencia en los pacientes con un CD + T-linfocitos por debajo de 50 / microlitro, en el que hubo una caída repentina en los niveles de ARN del VIH después de cambiar el TARGA (con Inglés. Terapia antirretroviral de gran actividad). 2 INFLAMABLE INMUNE Equipo de Reconstrucción - Los síntomas clínicos Los síntomas de este síndrome pueden ocurrir en cualquier momento a partir de 2 semanas a 2 años después del inicio del tratamiento. Estos deben incluir: linfadenopatía localizada, fiebre prolongada, la presencia de infiltrados pulmonares, aumento de la presión intracraneal, la uveítis, enfermedad de Graves. El curso clínico puede ser extendido, en los casos graves, la muerte. 3 INFLAMABLE Equipo de Reconstrucción INMUNE - mecanismo de patogénesis que subyace a esta asociación parece estar asociada con un fenómeno similar al tipo de reacción de hipersensibilidad IV. Es un reflejo de la rápida mejora del sistema inmune, que se produce después de la reducción de los niveles de ARN del VIH, y compensa el efecto inmunosupresor de la infección por VIH. En los casos graves, es la inclusión de fármacos inmunosupresores (tales como. Glucocorticoides) con el fin de suprimir el componente inflamatorio de este tipo de reacción, antes de que los efectos de la terapia antimicrobiana específica. CATEGORÍA: ENFERMEDADES INFECCIOSAS, SANIDAD, Microbiología, Inmunología Clínica Воспалительный синдром восстановления иммунитета (IRIS стоит. Восстановления иммунитета воспалительный синдром) в ходе инфицирования вирусом иммунодефицита человека (ВИЧ расшифровывается. Вирус иммунодефицита человека) показал парадоксальная ухудшение уже существующих, неочищенных или частично очищенных от оппортунистических инфекций после включения эффективной антиретровирусной терапии. Это условие особенно часто у пациентов с латентной инфекции mikobakteryjnymi ранее лечения. 1 ЛЕГКОВОСПЛАМЕНЯЮЩЕЕСЯ РЕКОНСТРУКЦИЯ TEAM иммунных - ЭПИДЕМИОЛОГИЯ Воспалительный синдром восстановления иммунитета может повлиять примерно 10-50% пациентов (ВИЧ-инфицированных) в зависимости от текущего клинического состояния. Это наблюдается чаще у больных с CD + Т-лимфоцитов ниже 50 / мкл, в котором произошло внезапное падение уровня РНК ВИЧ после переключения ВААРТ (с английского. Высокоактивной антиретровирусной терапии). 2 ЛЕГКОВОСПЛАМЕНЯЮЩЕЕСЯ РЕКОНСТРУКЦИЯ TEAM ИММУННАЯ - клинические симптомы Симптомы этого синдрома может произойти в любое время от 2 недель до 2-х лет после начала лечения. Они должны включать: локализованный лимфатических узлов, длительное повышение температуры, присутствие легочных инфильтратов, повышение внутричерепного давления, увеит, болезнь Грейвса. Клиническое течение может быть продлен, в тяжелых случаях, к летальному исходу. 3 ЛЕГКОВОСПЛАМЕНЯЮЩЕЕСЯ РЕКОНСТРУКЦИЯ TEAM ИММУННАЯ - Патогенез Механизм этого объединения, видимо, связано с явлением, подобным типом реакции IV гиперчувствительности. Это является отражением стремительного улучшения иммунной системы, которое происходит после снижения уровней РНК ВИЧ, и компенсирует иммуносупрессивной эффекта ВИЧ-инфекции. В тяжелых случаях это включение иммунодепрессантов (таких, как глюкокортикоиды.), Чтобы подавить воспалительный компонент реакции этого типа, прежде эффектов конкретного антибактериальной терапии. КАТЕГОРИИ: инфекционные заболевания, ЗДОРОВЬЕ ДЕЛ, микробиология, клиническая иммунология Reconstitution immunitaire du syndrome inflammatoire (IRIS est. Syndrome inflammatoire de restauration immunitaire) au cours de l'infection par le virus de l'immunodéficience humaine (VIH signifie. Virus de l'immunodéficience humaine) a révélé une aggravation paradoxale des pré-existante, non traitées ou partiellement traitées pour des infections opportunistes après la mise sous traitement antirétroviral efficace. Cette condition est particulièrement fréquente chez les patients atteints d'infections latentes mikobakteryjnymi non préalablement traités. 1 INFLAMMABLE RECONSTRUCTION ÉQUIPE DE IMMUNITAIRE - Épidémiologie du syndrome inflammatoire de reconstitution immunitaire peut affecter environ 10-50% des patients infectés par le VIH () en fonction de l'état clinique actuel. On observe le plus souvent chez les patients avec un CD + lymphocytes T en dessous de 50 / microlitre, où il y avait une baisse soudaine des niveaux d'ARN du VIH après la mise HAART (avec l'anglais. Thérapie antirétrovirale hautement active). 2 INFLAMMABLE équipe de reconstruction IMMUNITAIRE - symptômes cliniques Les symptômes de ce syndrome peuvent se produire à tout moment à partir de 2 semaines à 2 ans après le début du traitement. Ceux-ci devraient inclure: adénopathie localisée, fièvre prolongée, la présence d'infiltrats pulmonaires, augmentation de la pression intracrânienne, l'uvéite, la maladie de Basedow. L'évolution clinique peut être étendue, dans les cas graves, la mort. 3 INFLAMMABLE équipe de reconstruction IMMUNITAIRE - mécanisme de la pathogenèse sous-jacente de cette association semble être associée à un phénomène similaire à réaction de type IV d'hypersensibilité. Il est le reflet de l'amélioration rapide du système immunitaire, qui se produit après la réduction des taux d'ARN du VIH, et compense l'effet immunosuppresseur de l'infection par le VIH. Dans les cas graves, il est l'inclusion de médicaments immunosuppresseurs (tels que. Glucocorticoïdes) afin de supprimer la composante inflammatoire de ce type de réaction, avant que les effets de la thérapie antimicrobienne spécifique. CATÉGORIE: MALADIES INFECTIEUSES, SANTÉ, microbiologie, immunologie clinique Immunrekonstitution Entzündungssyndrom (IRIS steht. Immune Wiederentzündungssyndrom) im Verlauf der Infektion mit dem humanen Immundefizienz-Virus (HIV steht. Human Immunodeficiency Virus) offenbart eine paradoxe Verschlechterung der bereits bestehenden, unbehandelt oder nach dem Einschalten wirksame antiretrovirale Therapie teilweise für opportunistische Infektionen behandelt. Diese Bedingung ist bei Patienten mit latenten Infektionen mikobakteryjnymi zuvor unbehandelten besonders häufig. 1 ENTZÜNDBARER Wiederaufbauteam von Immun - EPIDEMIOLOGIE Entzündliche Immunrekonstitutionssyndrom können etwa 10-50% der Patienten (mit HIV infiziert) beeinflussen in Abhängigkeit von der aktuellen klinischen Status. Es wird häufig bei Patienten mit einer CD + T-Lymphozyten unter 50 / Mikroliter, in dem es einen plötzlichen Abfall der HIV-RNA-Werte nach dem Einschalten HAART beobachtet (mit englischen. Hochaktive antiretrovirale Therapie). 2 Entzündbare Reconstruction Team IMMUN - Klinische Symptome Die Symptome dieses Syndroms kann jederzeit von 2 Wochen bis 2 Jahren nach Beginn der Behandlung auftreten. Diese sollte beinhalten: lokalisierte Lymphadenopathie, verlängerte Fieber, das Vorhandensein von Lungeninfiltraten, erhöhtem Hirndruck, Uveitis, Morbus Basedow. Der klinische Verlauf kann verlängert werden, in schweren Fällen tödlich. 3 Entzündliche Reconstruction Team IMMUN - Pathogenese Mechanismus diese Assoziation zugrunde liegenden scheint mit einem Phänomen, ähnlich IV Überempfindlichkeitsreaktion Typ zugeordnet werden. Es ist ein Spiegelbild der schnellen Verbesserung des Immunsystems, die nach der Reduktion der Konzentrationen von HIV-RNA auftritt, und kompensiert die immunsuppressive Wirkung von HIV-Infektion. In schweren Fällen ist die Einbeziehung von Immunsuppressiva (wie. Glucocorticoide), um die Entzündungskomponente dieser Art von Reaktion zu unterdrücken, bevor die Effekte der spezifischen antimikrobiellen Therapie. KATEGORIE: Infektionskrankheiten, Health Affairs, Mikrobiologie, Klinische Immunologie Immune reconstitution inflammatory syndrome (IRIS stands. Immune restoration inflammatory syndrome) in the course of infection with human immunodeficiency virus (HIV stands for. Human immunodeficiency virus) revealed a paradoxical worsening of pre-existing, untreated or partially treated for opportunistic infections after turning on effective antiretroviral therapy. This condition is particularly common in patients with latent infections mikobakteryjnymi previously untreated. 1 FLAMMABLE RECONSTRUCTION TEAM OF IMMUNE - EPIDEMIOLOGY Inflammatory immune reconstitution syndrome can affect approximately 10-50% of patients (infected with HIV) depending on the current clinical status. It is observed most often in patients with a CD + T-lymphocytes below 50 / microliter, in which there was a sudden drop in HIV RNA levels after switching HAART (with English. Highly active antiretroviral therapy). 2 FLAMMABLE RECONSTRUCTION TEAM IMMUNE - CLINICAL SYMPTOMS The symptoms of this syndrome may occur at any time from 2 weeks to 2 years after initiation of treatment. These should include: localized lymphadenopathy, prolonged fever, the presence of pulmonary infiltrates, increased intracranial pressure, uveitis, Graves' disease. The clinical course may be extended, in severe cases, fatal. 3 FLAMMABLE RECONSTRUCTION TEAM IMMUNE - Pathogenesis mechanism underlying this association appears to be associated with a phenomenon similar to type IV hypersensitivity reaction. It is a reflection of the rapid improvement of the immune system, which occurs after the reduction of the levels of HIV RNA, and compensates for the immunosuppressive effect of HIV infection. In severe cases, it is the inclusion of immunosuppressive drugs (such as. 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