An adalimumab-induced late-onset immune reconstitution inflammatory syndrome treated with adalimumab

Immune reconstitution inflammatory syndrome (IRIS) is a violent inflammatory response in a patient previously immunosuppressed that discontinued this status and develops a paradoxical clinical deterioration, not explainable with drug-toxicity or opportunistic infection. We describe the case of a 59-year-old non-smoking man, treated for arthropathic psoriasis with adalimumab for 16 months who developed severe IRIS and pulmonary tuberculosis. The reintroduction of the TNF-blocker agent was effective.