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人疱疹病毒 8 相关的结肠卡波西肉瘤在溃疡性结肠炎中使用维多珠单抗治疗:病例报告及文献复习。

Human herpesvirus 8-associated colonic Kaposi's sarcoma during vedolizumab treatment in ulcerative colitis: a case report and review of the literature.

机构信息

Department of Surgery, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.

Istituto di Clinica Chirurgica, Università Cattolica del S.Cuore, Rome, Italy.

出版信息

BMC Gastroenterol. 2020 Mar 24;20(1):76. doi: 10.1186/s12876-020-01221-2.

Abstract

BACKGROUND

Kaposi's sarcoma (KS) is a rare vascular tumor associated with human herpesvirus (HHV)-8 infection. One of the variants of KS is defined iatrogenic and is overall reported in transplanted patient but also, although less frequently, in patients treated with long-standing immunosuppressive therapy, such as in inflammatory bowel disease including ulcerative colitis and Crohn's disease.

CASE PRESENTATION

Herein, we report the first case of KS in a human immunodeficiency virus (HIV)-negative 47-year old male with UC after treatment with the α4-β7 integrin inhibitor vedolizumab (VDZ). The patient underwent to colectomy for a medical refractory disease and the histological examination of the surgical specimen showed the typical findings of KS together with the HHV-8 positivity. The patient achieved a good health status, without any sign of disease recurrence.

CONCLUSIONS

In the present case, we can assume that VDZ may have promoted the reactivation of a latent HHV-8 infection endowed with oncogenic potentialities and, in turn, the onset of KS. We also briefly reviewed all the cases of KS in HIV-negative patients with inflammatory bowel disease.

摘要

背景

卡波西肉瘤(KS)是一种罕见的与人类疱疹病毒(HHV)-8 感染相关的血管肿瘤。KS 的一种变体被定义为医源性的,总体上见于移植患者,但也见于长期接受免疫抑制治疗的患者,例如溃疡性结肠炎和克罗恩病等炎症性肠病。

病例介绍

本文报告了首例 HIV 阴性的溃疡性结肠炎患者在使用 α4-β7 整合素抑制剂维多珠单抗(VDZ)治疗后发生 KS。该患者因疾病难治性而行结肠切除术,手术标本的组织学检查显示典型的 KS 表现,同时伴有 HHV-8 阳性。患者健康状况良好,无疾病复发迹象。

结论

在本病例中,我们可以假设 VDZ 可能促进了潜伏的 HHV-8 感染的重新激活,从而导致了 KS 的发生。我们还简要回顾了所有 HIV 阴性炎症性肠病患者的 KS 病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/238c/7092561/b9dba458118c/12876_2020_1221_Fig1_HTML.jpg

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