title: Acute renal failure associated with immune restoration inflammatory syndrome.
abstract: BACKGROUND
  A 30-year-old HIV-infected woman presented with fever and abdominal pain 4 days after initiation of highly active antiretroviral therapy (HAART), and 1 month after initiation of antimicrobial therapy for Mycobacterium tuberculosis infection. A diagnosis of immune restoration inflammatory syndrome (IRIS) was considered, and corticosteroids were started. Steroid therapy doses were progressively tapered, during which time the patient developed renal failure with enlarged kidneys. A renal biopsy showed acute interstitial nephritis. Extensive investigations failed to detect active infection. The efficacy of HAART was attested by increased CD4+ cell counts and undetectable viral replication.
  
  
  METHODS
  Physical examination, plasma viral load and CD4+ cell count, abdominal and renal ultrasound, renal and peritoneal biopsies, renal and liver function, chest X-ray, and bronchoalveolar lavage culture.
  
  
  METHODS
  Acute renal failure secondary to IRIS.
  
  
  RESULTS
  Prednisone therapy.
authors.affiliation: Department of Nephrology, Tenon Hospital, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Daugas
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Plaisier
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Boffa
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guiard-Schmid
authors.forename: Jerôme
authors.initials: J
authors.lastname: Pacanowski
authors.forename: Béatrice
authors.initials: B
authors.lastname: Mougenot
authors.forename: Pierre
authors.initials: P
authors.lastname: Ronco
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D005260:Female; D006801:Humans; D007154:Immune System Diseases / Q000503:physiopathology*; D011241:Prednisone / Q000494:pharmacology
chemical_list: D000893:Anti-Inflammatory Agents; D011241:Prednisone