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Case Reports in Transplantation
Volume 2017, Article ID 6290987, 5 pages
Case Report

Immune Reconstitution Inflammatory Syndrome Occurring in a Kidney Transplant Patient with Extrapulmonary Tuberculosis

1Department of Nephrology, Jersey Shore University Medical Center, Neptune, NJ 07753, USA
2Rowan University School of Osteopathic Medicine, Stratford, NJ 08084, USA
3American University of Antigua College of Medicine, Coolidge, Antigua and Barbuda
4Ocean Renal Associates, 210 Jack Martin Boulevard, Brick, NJ 08724, USA

Correspondence should be addressed to Jose Iglesias; moc.liamg@32saiselgij

Received 7 November 2016; Accepted 22 February 2017; Published 7 March 2017

Academic Editor: Binnaz Handan Ozdemir

Copyright © 2017 Jose Iglesias et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Tuberculosis (TB) occurring in solid organ transplantation (SOT) is associated with significant morbidity and mortality usually due to delays in diagnosis, drug toxicity encountered with antimycobacterial therapy, and drug-drug interactions. TB in SOT patients may mimic other infectious and noninfectious posttransplant complications such as posttransplant lymphoproliferative disorder (PTLD) and systemic cytomegalovirus infection. Immune reconstitution inflammatory syndrome (IRIS) is a host response resulting in paradoxical worsening of an infectious disease which occurs after the employment of effective therapy and reversal of an immunosuppressed state. We describe the development of immune reconstitution inflammatory syndrome (IRIS), a unique complication occurring during the treatment of extrapulmonary tuberculosis occurring after transplant which resulted from decreasing immunosuppression in a patient who received Alemtuzumab induction therapy. Although (IRIS) has been originally described in HIV/AIDS patients receiving highly active antiretroviral therapy (HAART), solid organ transplant recipients with diagnosed or occult TB whose immune system may undergo immune reconstitution during their posttransplant course represent a new high risk group.