Grattan-Smith D, Harrison L F, Singleton E B
Department of Radiology, Royal Children's Hospital, Melbourne, Australia.
Curr Probl Diagn Radiol. 1992 May-Jun;21(3):79-109. doi: 10.1016/0363-0188(92)90038-h.
The Acquired Immunodeficiency Syndrome (AIDS) has involved the pediatric age group and is especially prevalent in babies born of mothers who are intravenous drug abusers or prostitutes. Approximately 30% of children born to mothers who are seropositive for the human immunodeficiency virus (HIV) will develop HIV infection. There are several important differences in children and adults with AIDS. The incubation period of the disease is shorter, and initial clinical manifestations occur earlier in children. In addition, certain infections are more common in children, and the different types of malignancy, especially Kaposi's sarcoma, are unusual in the pediatric age group. The altered immune system involves both T cells and humoral immunity and increases susceptibility to a variety of infections, particularly opportunistic organisms. In this publication the complications of pediatric AIDS involving the lungs, cardiovascular system, gastrointestinal tract, genitourinary system, and neurological system are described. The most common pulmonary complications in our experience are Pneumocystis carinii pneumonia and pulmonary lymphoid hyperplasia. The spectrum of cardiovascular involvement in pediatric AIDS includes myocarditis, pericarditis, and infectious endocarditis. Gastrointestinal tract involvement is usually due to opportunistic organisms that produce esophagitis, gastritis, and colitis. Abdominal lymphadenopathy is a common finding either due to disseminating Mycobacterium avium-intracellulare infection or nonspecific lymphadenopathy. Although cholangitis is more commonly seen in adults, it may occur in children with AIDS and, in most cases, is due to related opportunistic infections. Genitourinary infections may be the first evidence of HIV disease. Cystitis, pyelonephritis, renal abscesses, and nephropathy with renal insufficiency are complications of pediatric AIDS. A variety of neurological abnormalities may occur in pediatric AIDS. The most common cause of neurological dysfunction in children with AIDS is HIV neuropathy. We present the many complications of AIDS in children demonstrated by a variety of imaging modalities, emphasizing the importance of diagnostic imaging in children with this disease.
获得性免疫缺陷综合征（艾滋病）已累及儿童年龄组，在静脉吸毒者或妓女所生的婴儿中尤为普遍。感染人类免疫缺陷病毒（HIV）呈血清阳性的母亲所生的孩子中，约30%会感染HIV。患有艾滋病的儿童与成人有几个重要差异。该病的潜伏期较短，儿童的初始临床表现出现得更早。此外，某些感染在儿童中更常见，而不同类型的恶性肿瘤，尤其是卡波西肉瘤，在儿童年龄组中并不常见。免疫系统的改变涉及T细胞和体液免疫，增加了对多种感染的易感性，尤其是对机会性生物体的易感性。在本出版物中，描述了小儿艾滋病累及肺部、心血管系统、胃肠道、泌尿生殖系统和神经系统的并发症。根据我们的经验，最常见的肺部并发症是卡氏肺孢子虫肺炎和肺淋巴组织增生。小儿艾滋病心血管受累的范围包括心肌炎、心包炎和感染性心内膜炎。胃肠道受累通常是由产生食管炎、胃炎和结肠炎的机会性生物体引起的。腹部淋巴结病是常见表现，其原因要么是播散性鸟分枝杆菌细胞内感染，要么是非特异性淋巴结病。虽然胆管炎在成人中更常见，但也可能发生在患有艾滋病的儿童中，在大多数情况下，是由相关的机会性感染引起的。泌尿生殖系统感染可能是HIV疾病的首发证据。膀胱炎、肾盂肾炎、肾脓肿和伴有肾功能不全的肾病是小儿艾滋病的并发症。小儿艾滋病可能会出现多种神经异常。患有艾滋病的儿童神经功能障碍最常见的原因是HIV神经病变。我们展示了通过各种成像方式显示的小儿艾滋病的许多并发症，强调了诊断成像在患有这种疾病的儿童中的重要性。
