Cappell M S, Hassan T
Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903-0019.
J Clin Gastroenterol. 1993 Oct;17(3):254-63. doi: 10.1097/00004836-199310000-00017.
Patients with the acquired immunodeficiency syndrome (AIDS) can develop pancreatic disease from causes unrelated to AIDS as well as AIDS-specific lesions. AIDS-specific causes include opportunistic infection, AIDS-associated neoplasia, and medications used to treat complications of AIDS. Reported pancreatic opportunistic pathogens include Mycobacterium tuberculosis, Mycobacterium avium intracellulare, Cryptococcus neoformans, Candida, Aspergillus, Toxoplasma gondii, Pneumocystis carinii, cytomegalovirus, herpes simplex, cryptosporidium, and microsporidium. Although cytomegaloviral pancreatic infection can occur without clinically evident pancreatic disease, cytomegalovirus can cause pancreatitis. Other opportunistic infections that can cause pancreatitis include Toxoplasma gondii, Cryptococcus neoformans, and Candida. Mycobacterial infection can produce a pancreatic abscess. Hepatobiliary or pancreatic duct infection by cytomegalovirus, cryptosporidium, and microsporidium causes irregular ductular narrowing and dilatation. This cholangiographic abnormality resembles the pattern found in idiopathic sclerosing cholangitis. Reported AIDS-associated pancreatic neoplasms include Kaposi's sarcoma and lymphoma. Pancreatic involvement is usually part of widely disseminated tumor and rarely produces clinical symptoms. Pentamidine, trimethoprim-sulfamethoxazole, and 2', 3'dideoxyinosine are medications commonly used in AIDS patients which can cause pancreatitis. Pentamidine also causes hypoglycemia or hyperglycemia.
获得性免疫缺陷综合征（艾滋病）患者可能因与艾滋病无关的病因以及艾滋病特异性病变而发生胰腺疾病。艾滋病特异性病因包括机会性感染、艾滋病相关肿瘤以及用于治疗艾滋病并发症的药物。报告的胰腺机会性病原体包括结核分枝杆菌、鸟分枝杆菌胞内复合体、新型隐球菌、念珠菌、曲霉菌、弓形虫、卡氏肺孢子虫、巨细胞病毒、单纯疱疹病毒、隐孢子虫和微孢子虫。虽然巨细胞病毒性胰腺感染可在无临床明显胰腺疾病的情况下发生，但巨细胞病毒可引起胰腺炎。其他可引起胰腺炎的机会性感染包括弓形虫、新型隐球菌和念珠菌。分枝杆菌感染可产生胰腺脓肿。巨细胞病毒、隐孢子虫和微孢子虫引起的肝胆管或胰管感染导致导管不规则狭窄和扩张。这种胆管造影异常类似于特发性硬化性胆管炎的表现。报告的艾滋病相关胰腺肿瘤包括卡波西肉瘤和淋巴瘤。胰腺受累通常是广泛播散性肿瘤的一部分，很少产生临床症状。喷他脒、甲氧苄啶 - 磺胺甲恶唑和2'，3'-双脱氧肌苷是艾滋病患者常用药物，可引起胰腺炎。喷他脒还可导致低血糖或高血糖。
