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Central Nervous System Immune Reconstitution Inflammatory Syndrome During Neutrophil Recovery in Pediatric Acute
Adnan Deniz1, Sevgi Tale2, Gökçe Cırdı3
1Departments of Pediatric Neurology, Kocaeli City Hospital.
Background:
Central nervous system (CNS) immune reconstitution inflammatory syndrome (IRIS) is well characterized in HIV but exceedingly rare in pediatric hematologic malignancies.
Observation:
An 11.5-year-old girl with acute myeloid leukemia (AML) and probable invasive pulmonary mold infection developed an expansive right parieto-occipital lesion with a 14 mm midline shift during neutrophil recovery. Evaluation excluded leukemic infiltration and active infection. Probable CNS IRIS was diagnosed; dexamethasone with continued antifungal therapy produced rapid clinical and radiologic recovery, with sustained AML remission at 29 months.
Conclusions:
CNS IRIS should be considered in pediatric AML with unexplained neurological deterioration during neutrophil recovery; timely corticosteroid therapy can be life-saving.
