消化管カポジ肉腫を発症した後天性免疫不全症候群患者8症例の臨床的検討  [in Japanese] Clinical Course and Management of Eight Cases of Gastrointestinal Kaposi's Sarcoma Related to Acquired Immunodeficiency Syndrome  [in Japanese]

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Author(s)

    • 太田 高志 OHTA Takashi
    • 国立病院機構大阪医療センター 消化器科 Department of Gastroenterology and Hepatology, Osaka National Hospital
    • 大田 真紀代 OTA Makiyo
    • 国立病院機構大阪医療センター 消化器科 Department of Gastroenterology and Hepatology, Osaka National Hospital
    • 巽 香織 TATSUMI Kaori
    • 国立病院機構大阪医療センター 消化器科 Department of Gastroenterology and Hepatology, Osaka National Hospital
    • 外山 隆 TOYAMA Takashi
    • 国立病院機構大阪医療センター 消化器科 Department of Gastroenterology and Hepatology, Osaka National Hospital
    • 三田 英治 MITA Eiji
    • 国立病院機構大阪医療センター 消化器科 Department of Gastroenterology and Hepatology, Osaka National Hospital

Abstract

我が国のHIV感染者,AIDS発症者は依然として増加傾向であり,カポジ肉腫(KS)の診断,治療に関わる機会は増えている.われわれは当院で経験したHIV感染を合併した消化管KS症例の臨床像をretrospectiveに検討した.患者は全例男性で,食道から大腸の全消化管に赤~暗赤色を呈する表面平滑な粘膜下腫瘍様の隆起性病変を認めた.1例は消化管KSからHIV感染症が明らかとなった.liposomal doxorubicin投与と抗HIV療法を行い,内視鏡で確認できた全例でKSは縮小し,全例生存している.消化管KSはHIV感染症の診断の契機ともなり,内視鏡医は特徴的な内視鏡像を熟知するべきと考える.

In Japan, the numbers of HIV infected patients and acquired immunodeficiency syndrome (AIDS) patients are still increasing. In relation to AIDS we sometimes diagnose gastrointestinal Kaposi's sarcoma (KS) and its endoscopic findings are very characteristic and should be known to endoscopists. Diagnosis of intestinal KS can be the opportunity to notice HIV infection and diagnose AIDS.<BR>This is a retrospective study of eight gastrointestinal KS patients related to AIDS and concerning their background, the location of KS and the therapeutic courses in the Osaka National Hospital.<BR>They were all male and the mean CD4 positive T lymphocyte counts was 114.9/ul, when diagnosed. HHV-8 infected cells were proven by immunohistochemistry performed in 5 of 5 cases. Gastrointestinal KS were found in both upper and lower gastrointestinal tracts (upper in 5 cases and lower in 5 cases). In endoscopy we could see the typical protrusion with bright redness in both upper and lower gastrointestinal tracts. We treated the patients with by liposomal doxorubicin and highly active antiretroviral therapy (HAART) in 4 cases, with HAART alone in 3 cases and with liposomal doxorubicin alone in 1 case. All cases are on a good therapeutic course with CR recognized in 2 cases, PR in 5 cases and unknown in 1 case, and are currently alive. We experienced 1 case in whom the diagnosis of gastrointestinal KS had lead to find the HIV infection.<BR>Now most cases of gastrointestinal KS are not directly life-threatening, but it could lead to early diagnosis of HIV infection. We should be familiar with endoscopic characteristics of gastrointestinal KS.

Journal

  • GASTROENTEROLOGICAL ENDOSCOPY

    GASTROENTEROLOGICAL ENDOSCOPY 53(7), 1786-1796, 2011-07-20

    Japan Gastroenterological Endoscopy Society

References:  29

Codes

  • NII Article ID (NAID)
    10029562442
  • NII NACSIS-CAT ID (NCID)
    AN00192102
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    03871207
  • Data Source
    CJP  J-STAGE 
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