Clinical and Endoscopic Features of Small Intestinal Lesions in Graft-versus-host Disease (GVHD) and Acquired Immunodeficiency Syndrome (AIDS) Mitsuru Seo 1 , Hyonji Kim 1 , Kanpei Saijo 1 , Takashi Matsuura 2 , Shinichi Aishima 3 , Tetsuya Eto 4 , Hideki Nakayama 5 1Department of Gastroenterology, Hamanomachi General Hospital, Fukuoka, Japan 2Department of Gastrointestinal Endoscopy, Hamanomachi General Hospital, Fukuoka, Japan 3Department of Pathology, Hamanomachi General Hospital, Fukuoka, Japan 4Department of Hematology, Hamanomachi General Hospital, Fukuoka, Japan 5Department of Pediatrics, Hamanomachi General Hospital, Fukuoka, Japan Keyword: 免疫不全 , 移植片対宿主病 , GVHD , 後天性免疫不全症候群 , AIDS , 小腸病変 pp.707-712
Published Date 2008/4/24
DOI https://doi.org/10.11477/mf.1403101353
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 We reviewed clinical and endoscopic findings of small intestinal lesions in graft-versus-host disease (GVHD) and acquired immunodeficiency syndrome (AIDS). Acute GVHD involving the small intestine characteristically manifests as secretory diarrhea. The terminal ileum is most vulnerable to GVHD. Erythema, mucosal edema and ulcers are more frequent endoscopic findings of GVHD in the terminal ileum. However, these findings are not specific to GVHD. On the other hand, diffuse sloughing of the mucosa is infrequent but highly specific to GVHD. Histologically, the presence of apoptosis of the glandular epithelium is characteristic in GVHD. This histological finding is seen regardless of apparent endoscopic lesions.

 Chronic diarrhea is common in patients with clinically apparent AIDS. In AIDS, chronic diarrhea is caused by opportunistic infections with protozoa, parasite, bacteria and viruses. The intestinal neoplasm occurs in patients with AIDS. Kaposi's sarcoma is the most frequent malignant tumor in the intestine. Kaposi's sarcoma appears as a reddish submucosal tumor.

 The comprehension of the endoscopic and the pathological findings of intestinal lesions is important in the management of patients with GVHD and AIDS, because these lesions influence the clinical course and the prognosis of patients.

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