{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:31:19Z","timestamp":1777901479668,"version":"3.51.4"},"reference-count":16,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,5,31]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>We present the case of a patient with HIV and tuberculosis (TB) coinfection who initially developed paradoxical TB immune reconstitution inflammatory syndrome (TB-IRIS) post-antituberculous treatment and post-antiretroviral therapy initiation. Despite being managed effectively, lymphadenitis recurred as many as three times over the course of several years. Due to consistent culture-negative lymph node biopsies, the recurring lymphadenitis was eventually deemed inflammatory rather than microbiological recurrences. Cessation of anti-TB treatment led to symptom remission followed by a long asymptomatic period, corroborating the immunological nature of the episodes. However, 5 and 6 years after cessation of anti-TB treatment, respectively, lymphadenitis returned. In both instances, her symptoms regressed without treatment with anti-TB drugs. This case underscores the complexities of managing TB-IRIS and the necessity of differentiating between paradoxical TB-IRIS and other paradoxical reactions for appropriate treatment decisions. Recognition of such distinctions is crucial in guiding effective therapeutic interventions in TB-HIV coinfection scenarios.<\/jats:p>","DOI":"10.1136\/bcr-2023-259211","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T03:10:16Z","timestamp":1718593816000},"page":"e259211","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Tuberculosis immune reconstitution syndrome (TB-IRIS) followed by recurring lymphadenitis up to 8 years post-antituberculous treatment"],"prefix":"10.1136","volume":"17","author":[{"given":"Ole","family":"Skouvig Pedersen","sequence":"first","affiliation":[{"name":"Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7415-6724","authenticated-orcid":false,"given":"Trine \u00d8rh\u00f8j","family":"Barkholt","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stine","family":"Horsk\u00e6r Madsen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Aarhus University Hospital, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frauke","family":"Rudolf","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,6,16]]},"reference":[{"key":"2025082622563021000_17.6.e259211.1","unstructured":"Global tuberculosis report 2023, licence: CC BY-NC-SA 3.0 IGO. 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