Rosamar Eulira Fontes Rezende1, Rafael Lima Kahwage2, Tarciana Vieira da Costa2, Alcyone Artioli Machado2, Mariângela Ottoboni Brunaldi3, Rafael Kemp4, José Luiz Pimenta Módena4. 1. Department of Clinical Medicine, Division of Gastroenterology, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Monte Alegre, CEP 14048-900, Ribeirão Preto, São Paulo, Brazil. Electronic address: rosamarrezende@uol.com.br. 2. Department of Clinical Medicine, Division of Gastroenterology, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Monte Alegre, CEP 14048-900, Ribeirão Preto, São Paulo, Brazil. 3. Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil. 4. Department of Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.
Abstract
BACKGROUND: Kaposi's sarcoma (KS) is the most common neoplasm among HIV-infected individuals. The frequency of involvement of KS in the gastrointestinal (GI) tract and the associated epidemiological, immune, endoscopic, and histopathological features in HIV-infected patients, were evaluated in this study. METHODS: A review of the medical and endoscopy reports of 1428 HIV-infected patients, who had undergone upper GI endoscopy at the Endoscopy Service, Clinical Hospital, Faculty of Medicine of Ribeirão Preto between January 1999 and June 2009, was performed. Clinical, epidemiological, immunological, endoscopic, and histological data were collected. RESULTS: Twenty-seven (1.9%) patients were diagnosed with GI KS. Patients were predominantly male (81.5%). Sexual activity was the main route of HIV transmission (81.5%). Cutaneous involvement was noted in 21 patients (78%). Fifteen patients (55%) received highly active antiretroviral therapy for a mean duration of 12.6 weeks (range 2-52 weeks) before endoscopy. GI lesions were mainly found in the stomach (55%). Analysis of the immunohistochemical methods HHV8 LNA-1, CD31, and CD34 for the diagnosis of gastric KS indicated high agreement (kappa=0.63, 95% confidence interval 0.32-0.94). There was no relationship between CD4 levels (p=0.34) or HIV viral load (p=0.99) and HHV8 LNA-1 positivity in gastric KS. CONCLUSIONS: GI KS is an infrequent finding in patients with HIV infection. Among those with GI KS, 80% had concomitant skin lesions. Immunohistochemical methods for CD31, CD34, and LNA-1 were important tools in the diagnostic assessment of lesions suggestive of KS in the GI tract. Further studies are required to confirm these data, and the need for routine endoscopic investigation of the GI tract in HIV-infected patients with cutaneous KS should be assessed.
BACKGROUND:Kaposi's sarcoma (KS) is the most common neoplasm among HIV-infected individuals. The frequency of involvement of KS in the gastrointestinal (GI) tract and the associated epidemiological, immune, endoscopic, and histopathological features in HIV-infectedpatients, were evaluated in this study. METHODS: A review of the medical and endoscopy reports of 1428 HIV-infectedpatients, who had undergone upper GI endoscopy at the Endoscopy Service, Clinical Hospital, Faculty of Medicine of Ribeirão Preto between January 1999 and June 2009, was performed. Clinical, epidemiological, immunological, endoscopic, and histological data were collected. RESULTS: Twenty-seven (1.9%) patients were diagnosed with GI KS. Patients were predominantly male (81.5%). Sexual activity was the main route of HIV transmission (81.5%). Cutaneous involvement was noted in 21 patients (78%). Fifteen patients (55%) received highly active antiretroviral therapy for a mean duration of 12.6 weeks (range 2-52 weeks) before endoscopy. GI lesions were mainly found in the stomach (55%). Analysis of the immunohistochemical methods HHV8 LNA-1, CD31, and CD34 for the diagnosis of gastric KS indicated high agreement (kappa=0.63, 95% confidence interval 0.32-0.94). There was no relationship between CD4 levels (p=0.34) or HIV viral load (p=0.99) and HHV8 LNA-1 positivity in gastric KS. CONCLUSIONS:GI KS is an infrequent finding in patients with HIV infection. Among those with GI KS, 80% had concomitant skin lesions. Immunohistochemical methods for CD31, CD34, and LNA-1 were important tools in the diagnostic assessment of lesions suggestive of KS in the GI tract. Further studies are required to confirm these data, and the need for routine endoscopic investigation of the GI tract in HIV-infectedpatients with cutaneous KS should be assessed.
Authors: Catarina Tenório de Lima; Paulo Sérgio Ramos de Araújo; Heberton Medeiros de Teixeira; Josemir Belo Dos Santos; Vera Magalhães da Silveira Journal: An Bras Dermatol Date: 2017 Mar-Apr Impact factor: 1.896
Authors: Diana Curras-Martin; Natasha Campbell; Albino Copca-Alvarez; Kathleen Casey; William A Lerner; Mohammad A Hossain Journal: ACG Case Rep J Date: 2019-05-15
Authors: Rafaela Barbirato Fardin; Luiz Arhur Calheiros Leite; Luanna Mayara Dos Santos Bezerra; Priscilla Maris Pereira Alves; Layanne Lima Dos Santos; Marília de Andrade Salvá; Antônio Luiz Soares Moura Rezende Filho; Gilberto Salustiano Lima; Juliana de Amorim Matos; Sônia Maria Soares Ferreira; Ducy Lily Joazeiro de Farias Costa Journal: Am J Case Rep Date: 2018-07-25