在开始抗逆转录病毒治疗时出现的酷似克罗恩病的特发性回肠末端溃疡

Idiopathic Terminal Ileal Ulceration Mimicking Crohn's in the Setting of Antiretroviral Therapy Initiation.

作者信息

Nasir Umair M, Paer Jeffrey, Jiang Yi, Mirani Neena M, Ahlawat Sushil, Pergament Kathleen M

机构信息

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ.

Department of Pathology and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, NJ.

出版信息

ACG Case Rep J. 2020 Dec 16;7(12):e00489. doi: 10.14309/crj.0000000000000489. eCollection 2020 Dec.

DOI:10.14309/crj.0000000000000489

PMID:33354585

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7748168/

Abstract

Antiretroviral therapy (ART) has precipitously decreased the morbidity associated with human immunodeficiency virus but can unmask and exacerbate opportunistic infections and autoimmune diseases. Various diseases have been reported in association with ART initiation, but there is scant literature describing inflammatory colitis in the setting of ART initiation. We present a 39-year-old man with chronic untreated human immunodeficiency virus and central nervous system toxoplasmosis who developed persistent diarrhea after initiation of ART. A comprehensive infectious workup was negative. Computed tomography demonstrated terminal ileum enteritis, which was confirmed by colonoscopy. Biopsy of the terminal ileum revealed fibrinous exudate and granulation tissue.

摘要

抗逆转录病毒疗法（ART）已显著降低了与人类免疫缺陷病毒相关的发病率，但可能会揭示并加重机会性感染和自身免疫性疾病。已有多种疾病被报道与开始ART治疗有关，但关于在开始ART治疗的情况下发生炎症性结肠炎的文献却很少。我们报告一名39岁男性，患有未经治疗的慢性人类免疫缺陷病毒感染和中枢神经系统弓形虫病，在开始ART治疗后出现持续性腹泻。全面的感染检查结果为阴性。计算机断层扫描显示末端回肠炎，结肠镜检查证实了这一诊断。末端回肠活检显示有纤维蛋白渗出物和肉芽组织。