Ghantasala Vaishnavi, Palvia Aadi, Damera Abhiram Rao, Salomao Marcela, Harris Lucinda A, Hashash Jana G, Gnanapandithan Karthik
Department of Internal Medicine, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India.
Department of Internal Medicine, Kharghar Medicity Hospital, Navi Mumbai, Maharashtra, India.
Am J Case Rep. 2025 Jul 12;26:e947163. doi: 10.12659/AJCR.947163.
BACKGROUND Adalimumab is a humanized therapeutic monoclonal antibody that blocks tumor necrosis factor-alpha (TNF-a). Kaposi sarcoma is a rare complication associated with adalimumab treatment. It is a cancer with an indolent course and is highly responsive to chemotherapy agents. This report describes the case of a 65-year-old HIV-negative man with gastrointestinal Kaposi sarcoma associated with adalimumab treatment for cardiac sarcoidosis. CASE REPORT A 65-year-old man with cardiac sarcoidosis on adalimumab presented with gastrointestinal bleeding. Endoscopic evaluation revealed Kaposi sarcoma involving the stomach and colon, confirmed by histopathology showing spindle cell proliferation with vascularity and human herpesvirus-8 positivity. HIV testing was negative. Adalimumab was discontinued, and he was treated with paclitaxel. He improved, and the lesions were resolved with treatment as demonstrated in repeat endoscopy. The patient was moved to active surveillance. CONCLUSIONS The endoscopic and clinical presentations of gastrointestinal Kaposi sarcoma are highly variable. In most cases, definitive diagnosis requires endoscopic biopsy and histopathology. Multiple and deep endoscopic biopsies are crucial to avoid false-negative results. Maintaining a high index of suspicion of Kaposi sarcoma in those on immunosuppressants like adalimumab is vital for the timely diagnosis and treatment of this potentially fatal condition. Such patients are usually responsive to withdrawal of the immunosuppressive agent and/or chemotherapy.
阿达木单抗是一种可阻断肿瘤坏死因子-α（TNF-α）的人源化治疗性单克隆抗体。卡波西肉瘤是与阿达木单抗治疗相关的一种罕见并发症。它是一种病程进展缓慢的癌症，对化疗药物高度敏感。本报告描述了一名65岁HIV阴性男性的病例，该患者因心脏结节病接受阿达木单抗治疗后出现胃肠道卡波西肉瘤。
一名因心脏结节病接受阿达木单抗治疗的65岁男性出现胃肠道出血。内镜评估显示胃和结肠有卡波西肉瘤，组织病理学证实为梭形细胞增殖伴血管形成及人疱疹病毒8型阳性。HIV检测为阴性。停用阿达木单抗，患者接受紫杉醇治疗。患者病情改善，重复内镜检查显示病变经治疗后消退。患者转为主动监测。
胃肠道卡波西肉瘤的内镜表现和临床表现差异很大。在大多数情况下，明确诊断需要内镜活检和组织病理学检查。多次及深部内镜活检对于避免假阴性结果至关重要。对于使用阿达木单抗等免疫抑制剂的患者，保持对卡波西肉瘤的高度怀疑指数对于及时诊断和治疗这种潜在致命疾病至关重要。此类患者通常对停用免疫抑制剂和/或化疗有反应。
