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IRIS - immune reconstitution inflammatory syndrome
Aug 6, 2006

DEAR DOC, I WAS TESTED + IN NOV 2005 AND WAS HOSPITALISED FOR HIGH FEVER ,LOW PLATELLETS , LYMPH NODES . INITIALLY THEY KEPT ON TESTING AND SUSPECTING CANCER BUT AFTER BEING TESTED HIV + STARTED ME ON EFAVIRENZ, TENOFOVIR DISOPROXIL FUMARATE/AND LAMIVUDINE . AFTER THIS MY PROBLEMS STARTED BEING SOLVED ONE BY ONE AND THE LYMPH NODES WHICH WERE TESTED AS SUSPECTED CASTLEMAN DESEASE INITIALLY BEFORE BEING TESTED + WAS LINKED TO BEING +. AFTER DISCHARGE FROM HOSPITAL I GOT FVER AGAIN BUT MAINLY DUE TO COLD AND SOUR THROAT WHICH WAS TREATED WITH ANTIBIOTICS . IN MARCH 2006 I GOT HIGH FEVER AGAIN AN INSPITE OF TRYING DIFFERENT ANTIBIOTICS ,COULD NOT BE CONTROLEED ,I ALSO DEVELOPED LYMPH NODES IN THE NECK AND GROIN. VERY SMALL OF THE SIZE OF HALF PEAS . AFTER ABOUT 10 DAYS OF FEVER AND TRYING THREE DIFFRENT ANTIBIOTICS MY HIV DOC TERMED MY CONDITION AS IRIS, WHICH IS A RARE APPEARENCE OF SOME OLD DESEASE WHEN ONE STARTS RECOVERING AND HIS CD4 COUNTS START GOING UP . HE GAVE ME A MALARIA TABLEC COURSE WHICH CONTROLLED MY HIGH FEVER IMMIDIATELY.

MY QUESTIONS ARE--- 1. PLEASE INFORM MORE ABOUT IRIS AND WILL IT OCCUR AGAIN .IS MY DOC RIGHT IN THE DIAGNOSE , THOUGH THE MALARIA TAB CONTROLLED MY FEVER EFFECTIVELY WAS IT REALLY IRIS. 2. WHY DID I GET LYMPH NODES AGAIN .THE FNAC REPORT SAYS ... SMEARS AREV COMPOSED OF SHEETS OF ORGANISED LYMPHOID CELLS WITH LYMPHOCYTES IN VARIOUR STAGE OF MATURATION .NUMEROUS PLASMA CELLS AND IMMUNOBLAST ARE SEEN . NO EVIDENCE OF GRANULOMAS NEGATIVE FOR MALIGNENT ELLS. COMMENTS... CONSISTENT WITH REACTIVE LYMPH NODES.

NOW MY DOC SAYS THE LYMPH NODES WILL GO IN DUE COURSE WITH MY HIV MEDICINES ONLY . IS IT RIGHT , DO I NEED ANY OTHER MEDICINE ?

FURTHER PLEASE ADVISE IF MY REGIMEN OF MEDICINE GOOD , AND IS THERE ANY THING BETTER THAN THIS I CAN GET ANY WHERE , PLEASE ADVISE I AM FROM INDIA .

THANKS A LOT

AND REQUEST U TO PLEASE EXPLAIN IN DETAIL.

Response from Dr. Pierone

Hello and thanks for posting.

IRIS is the acronym for immune reconstitution inflammatory syndrome and based on the description of events in your post it seems to fit your situation. Here is a link to some information on IRIS. I think you are on a good regimen and things should improve with time. Let us know how things turn out and best of luck!



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