Yang M T, Ko F T, Cheng N Y, Lin K Y, Wang C S, Siauw C P, Shih L S, Liao S T
Department of Internal Medicine, Taipei Municipal Jen-Ai Hospital, Taiwan, Republic of China.
Kaohsiung J Med Sci. 1996 Nov;12(11):624-9.
In Taiwan, numbers of patients with the acquired immunodeficiency syndrome (AIDS) have been increasing in recent years. We present esophageal disease of different causes in 5(16%) heterosexual men among 31 AIDS patients over a 5-year period. Major symptoms included mild dysphagia in 4 (80%) patients and odynophagia in 3 (60%) patients. The duration of symptoms varied from 3 days to 6 months. The symptoms occurred before the diagnosis of AIDS in 3 patients. At esophagogastroduodenoscopy (endoscopy), all 5 patients had esophagitis and/or esophageal ulcers proved by histopathologic evaluation. Four had Candida esophagitis, 3 had cytomegalovirus esophagitis/ulcers and 2 had idiopathic esophageal ulcerations (IEU). Three patients had different esophagitis/ulcers at the same time or during follow-up. The median CD4 lymphocyte count at the time of diagnosis of esophageal disease was 12.2 cells/mm3 (range, 3 to 35 cells/mm3). The endoscopic pictures of the different causes of esophagitis/ ulcers lack uniformity in number, size and appearance. These observations make a conclusion that all AIDS patients with an esophageal disease should undergo endoscopy with biopsy to obtain a definitive diagnosis.
在台湾，近年来获得性免疫缺陷综合征（艾滋病）患者的数量一直在增加。我们呈现了在5年期间31例艾滋病患者中5例（16%）异性恋男性的不同病因食管疾病。主要症状包括4例（80%）患者有轻度吞咽困难，3例（60%）患者有吞咽痛。症状持续时间从3天到6个月不等。3例患者的症状出现在艾滋病诊断之前。在食管胃十二指肠镜检查（内镜检查）时，所有5例患者经组织病理学评估均证实有食管炎和/或食管溃疡。4例有念珠菌性食管炎，3例有巨细胞病毒性食管炎/溃疡，2例有特发性食管溃疡（IEU）。3例患者在同一时间或随访期间有不同的食管炎/溃疡。食管疾病诊断时CD4淋巴细胞计数的中位数为12.2个细胞/mm³（范围为3至35个细胞/mm³）。不同病因的食管炎/溃疡的内镜图像在数量、大小和外观上缺乏一致性。这些观察结果得出结论，所有患有食管疾病的艾滋病患者都应接受内镜检查并活检以获得明确诊断。
