Contribution of arterial spin-labelling MRI in a case with immune reconstitution inflammatory syndrome

BMJ Case Rep. 2017 Jul 6:2017:bcr2017219860. doi: 10.1136/bcr-2017-219860.

Abstract

Central nervous system immune reconstitution inflammatory syndrome (CNS-IRIS), which occurs most often in HIV-infected patients, is an exacerbation of inflammatory reactions related to opportunistic infections as well as primary CNS malignancies both of which mostly occur in HIV-infected patients. However, differential diagnoses are challenging both clinically and radiologically. We describe a patient with CNS-IRIS due to toxoplasmosis whose 11C-methionine uptake suggested lymphoma but whose arterial spin-labelling MRI led to the correct diagnosis.

Keywords: Neuroimaging; Radiology.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • Antiretroviral Therapy, Highly Active / adverse effects
  • Central Nervous System / blood supply
  • Central Nervous System / diagnostic imaging*
  • Central Nervous System / immunology
  • Diagnosis, Differential
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Humans
  • Immune Reconstitution / physiology
  • Immune Reconstitution Inflammatory Syndrome / cerebrospinal fluid
  • Immune Reconstitution Inflammatory Syndrome / chemically induced
  • Immune Reconstitution Inflammatory Syndrome / diagnostic imaging*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Toxoplasma / genetics
  • Toxoplasmosis, Cerebral / complications*
  • Toxoplasmosis, Cerebral / drug therapy
  • Toxoplasmosis, Cerebral / parasitology