Successful rescue TNF-α blocking for Mycobacterium genavense - Related immune reconstitution inflammatory syndrome: A case report

Hugo Bes-Berlandier; Margaux Garzaro; Claire Rouzaud; Sylvain Bodard; Emmanuelle Bille; Maxence Ficheux; Dominique Cazals-Hatem; Nicolas Veziris; Fanny Lanternier; Olivier Lortholary

doi:10.1016/j.heliyon.2024.e29341

Successful rescue TNF-α blocking for Mycobacterium genavense - Related immune reconstitution inflammatory syndrome: A case report

Heliyon. 2024 Apr 6;10(7):e29341. doi: 10.1016/j.heliyon.2024.e29341. eCollection 2024 Apr 15.

Authors

Hugo Bes-Berlandier¹, Margaux Garzaro^{1

2}, Claire Rouzaud¹, Sylvain Bodard^{2

3}, Emmanuelle Bille^{2

4}, Maxence Ficheux⁵, Dominique Cazals-Hatem^{2

6}, Nicolas Veziris⁷, Fanny Lanternier^{1

2}, Olivier Lortholary^{1

2}

Affiliations

¹ Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants-malades, Assistance publique-Hôpitaux de Paris, 149 rue de Sèvres, 75743, Paris, France.
² Université Paris Cité, 15 rue de l'école de Médecine, 75006, Paris, France.
³ Service de Radiologie adulte, Hôpital-Necker-Enfants-malades, Assistance publique-Hôpitaux de Paris, 149 rue de Sèvres, 75743, Paris, France.
⁴ Service de Microbiologie, Hôpital Necker-Enfants-malades, Assistance publique-Hôpitaux de Paris, 149 rue de Sèvres, 75743, Paris, France.
⁵ Service de Néphrologie, Centre Hospitalier universitaire de Caen Normandie, Avenue de la Côte de Nacre, 14033, Caen, France.
⁶ Département de Pathologie, Hôpital Beaujon, Assistance publique-Hôpitaux de Paris, 100, Boulevard Leclerc, 92118, Clichy, France.
⁷ Sorbonne Université, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), UMR, 1135, Department of Bacteriology, Saint-Antoine Hospital, APHP. Sorbonne-Université, Centre National de Référence des Mycobactéries, Paris, France.

Abstract

Immune reconstitution inflammatory syndrome (IRIS) has been reported in immunocompromised patients with disseminated Mycobacterium genavense. Management relies on high-dose corticosteroids. We describe two cases of late-onset corticosteroid-refractory IRIS related to disseminated infection in a HIV-positive patient and a renal transplant patient who had a favorable outcome with a monoclonal TNF-α blocker.

Keywords: Case report; IRIS; Infliximab; Monoclonal anti-TNF-α antibody; mycobacterium genavense.

Publication types

Case Reports