Clinical and Pathological Aspects of Gastrointestinal Lesions in AIDS Yoshiya Yamada 1 , Toru Igari 2 , Morio Koike 2 1Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital 2Department of Pathology, Tokyo Metropolitan Komagome Hospital Keyword: AIDS , CD4 , CMV , Kaposi's sarcoma , MAC pp.845-855
Published Date 1999/6/25
DOI https://doi.org/10.11477/mf.1403103078
  • Abstract
  • Look Inside
  • Cited by

 Even following prolonged treatment with the most effective current antiviral drugs and protease inhibitors, the same characteristic gastrointestinal lesions still remain in the endoscopic findings of AIDS patients. In other words, AIDS is an incurable disease. Some of these gastrointestinal lesions, the result of opportunistic infections common in AIDS patients, are related to the CD4 count, which is one of the indicators of the level of immunological protection. For example, in cases of esophageal candidiasis, the CD4 level was less than 200/mm3; with Mycobacterium avium complex(MAC), the CD4 level was less than 75/mm3 ; and with CMV (cytomegalovirus) ulcers or erosion in the esophagus or the stomach, the CD4 count was less than 50/mm3. Candidiasis is recognized by the thick circular white coating in the esophagus ; CMV ulcers by their punched-out shape ; and MAC by frosted duodenal mucosa. All three conditions are diagnosed by means of biopsy specimens. Other lesions include malignant tumors, mostly Kaposi's sarcoma in the stomach or the duodenum or malignant lymphoma in the stomach. Kaposi's sarcoma shows submucosal nodule lesions with reddish mucosa. Sometimes, there is a depression in the top of the lesion. It is also able to be diagnosed through characteristic biopsy specimens.

Copyright © 1999, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院