Abstract
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.
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.
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.
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.
