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医源性卡波西肉瘤:揭示胃肠道表现及治疗意义的独特病例

Iatrogenic Kaposi's Sarcoma: A Unique Case Unraveling Gastrointestinal Manifestations and Therapeutic Implications.

作者信息

Belabbes Fatima Zahra, Fadili Hajar, Allaoui Abir, Kaikani Wafaa, Agharbi Fatima Zahra

机构信息

Gastroenterology and Hepatology, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

Laboratory Medicine, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

出版信息

Cureus. 2024 Mar 30;16(3):e57279. doi: 10.7759/cureus.57279. eCollection 2024 Mar.

Abstract

Kaposi's sarcoma (KS), linked to human herpesvirus 8 (HHV8), manifests in various clinical forms with iatrogenic KS uniquely tied to immune dysregulation induced by medical interventions. This study describes a 58-year-old male of sub-Saharan origin with a medical history of segmental and focal hyalinosis treated with methylprednisolone and mycophenolate mofetil. The patient developed skin lesions on both thighs, accompanied by post-prandial vomiting and abdominal pain. Clinical examination revealed flesh-colored nodules on the thighs and inguinal lymphadenopathy. Biopsy confirmed the diagnosis of KS, exhibiting positive nuclear labeling to anti-HHV8 and negative HIV serology. Additionally, radiological findings from the thoracic-abdominal-pelvic computed tomography (CT) scan significantly contribute to our understanding of the multiorgan involvement associated with KS in this case, providing valuable insights for diagnosis and therapeutic considerations. This case highlights the iatrogenic subtype of KS, linked to immunosuppression from prior medical interventions. Notably, gastrointestinal involvement was evident, with lesions in the stomach and small intestine. Intravenous paclitaxel administration resulted in a positive clinical response. This study underscores the importance of clinical vigilance, endoscopic evaluation, and early intervention in the nuanced diagnosis and management of iatrogenic KS.

摘要

卡波西肉瘤(KS)与人类疱疹病毒8型(HHV8)有关,表现为多种临床形式,医源性KS与医疗干预引起的免疫失调密切相关。本研究描述了一名58岁的撒哈拉以南地区男性,有节段性和局灶性透明变性病史,曾接受甲基强的松龙和霉酚酸酯治疗。患者双大腿出现皮肤病变,伴有餐后呕吐和腹痛。临床检查发现大腿有肉色结节和腹股沟淋巴结病。活检确诊为KS,抗HHV8核标记呈阳性,HIV血清学呈阴性。此外,胸腹部盆腔计算机断层扫描(CT)的影像学检查结果对我们理解该病例中与KS相关的多器官受累有很大帮助,为诊断和治疗考量提供了有价值的见解。该病例突出了医源性KS亚型,与先前医疗干预导致的免疫抑制有关。值得注意的是,胃肠道受累明显,胃和小肠有病变。静脉注射紫杉醇产生了积极的临床反应。本研究强调了临床警惕、内镜评估和早期干预在医源性KS细微诊断和管理中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d5/11057916/6a2d26a11414/cureus-0016-00000057279-i01.jpg

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