Department of Surgery, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
Istituto di Clinica Chirurgica, Università Cattolica del S.Cuore, Rome, Italy.
BMC Gastroenterol. 2020 Mar 24;20(1):76. doi: 10.1186/s12876-020-01221-2.
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.
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.
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.
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。
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。
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。