Immune reconstitution inflammatory syndrome in a patient with progressive multifocal leukoencephalopathy

摘要: Progressive multifocal leukoencephalopathy (PML) is a severe opportunistic infection of the central nervous system. A 52-year-old man with HIV infection, recently started on antiretroviral therapy, presented symptoms mental cloudiness, blurry vision and ataxia. MRI brain showed nodular perivascular space enhancement surrounding vasogenic oedema midline shift. lumbar puncture revealed non-inflammatory cerebrospinal fluid was positive for JC virus. As patient developed worsening in setting initiation therapy immune recovery, diagnosis virus-associated reconstitution inflammatory syndrome (IRIS) made. With recent literature use CCR5 antagonist maraviroc PML, our noted to have improvement PML IRIS. This first case an HIV-positive successfully treated IRIS maraviroc, as verified by review; also, has clinical implications improving outcome