Albert Einstein College of Medicine, Bronx, NY, USA.
Weill Cornell Medicine, New York, NY, USA.
Mod Pathol. 2018 Jun;31(6):844-861. doi: 10.1038/s41379-018-0015-9. Epub 2018 Feb 5.
Immune compromise may result from genetic abnormalities, HIV/AIDS, or consequences of therapy for neoplastic and autoimmune diseases. Many immunocompromised patients develop severe gastrointestinal symptoms, particularly diarrhea, accompanied by non-specific or mild endoscopic abnormalities; mucosal biopsy with pathologic interpretation has a major role in the diagnosis and management of these patients. Immunocompromised individuals are at risk for all the diseases that affect those with a healthy immune system, but they are also prone to other illnesses that rarely affect immunocompetent patients. This review discusses the gastrointestinal manifestations of primary and acquired immunodeficiency, chemotherapy-related injury, and infections that show a predilection for immunocompromised patients. Key histologic features and relevant differential diagnoses are emphasized.
免疫功能受损可能由遗传异常、HIV/AIDS 或肿瘤和自身免疫性疾病治疗的后果引起。许多免疫功能低下的患者会出现严重的胃肠道症状，尤其是腹泻，并伴有非特异性或轻度内镜异常；黏膜活检和病理解读在这些患者的诊断和治疗中具有重要作用。免疫功能低下的个体面临所有影响免疫系统健康的人的疾病风险，但他们也容易患上其他很少影响免疫功能正常患者的疾病。这篇综述讨论了原发性和获得性免疫缺陷、与化疗相关的损伤以及易发生于免疫功能低下患者的感染的胃肠道表现。强调了关键的组织学特征和相关鉴别诊断。
