We briefly report two cases of HIV/AIDS-associated Kaposi’s sarcoma affecting the gastrointestinal tract. Both patients were seen at Edenvale General Hospital, Johannesburg, South Africa

Jann-Kruger, C

Mosiane, P

Naidoo, P

Patel, N

English

AJOL - African Journals Online

IN PRACTICE986       October 2016, Vol. 106, No. 10Case reportsA 71-year-old man presented with a 2-month history of malaise, weakness, dizziness, loss of weight and diarrhoea. He had no significant past medical, surgical or social history. His retroviral disease status was unknown. On examination he was cachexic and pale with no other significant clinical findings. He was subsequently admitted for investigation. Blood results on admission were as follows: haemoglobin 5.5 g/dL and HIV-positive, with an absolute CD4 count of 116 cells/µL. There were no significant findings on abdominal ultrasound.The second case was a 49-year-old woman who presented with diarrhoea, vomiting and weakness of 3 months’ duration. In addition she reported a ‘rash’ that had preceded these symptoms. She was HIV-positive with a CD4 count of 89 cells/µL and had been on highly active antiretroviral therapy (HAART) for 1  month. In addition she was being treated for pulmonary tuberculosis, and was in the intensive phase of therapy. On examination she appeared wasted and pale and had violaceous skin lesions, with similar lesions in her mouth. Her haemoglobin concentration was 4.8 g/dL.As part of the workup for symptomatic anaemia, both patients underwent endo scopy. Oesophagogastroduodenoscopy demonstrated multiple broad-based umbilicated violaceous nodules in the oesophagus, stomach and duo-denum. Colonoscopy demonstrated broad-based violaceous nodules throughout the large intestine, some of which were circumferential and partially occluded the lumen of the large intestine. Selected images obtained during endoscopy are presented in Figs 1 (A and B) and 2 (A).A biopsy of lesions identified during endo-scopy confirmed Kaposi’s sarcoma (KS) (Fig. 2, B).The first patient was started on HAART and referred to the medical onco logy depart-ment at Charlotte Maxeke Johannesburg Academic Hospital for further management. The patient defaulted and was lost to follow-up. The file for the second patient was lost. All attempts to contact both patients were unsuccessful.Ethical clearance was received from the University of the Witwatersrand Human Research Ethics Committee (Ref. no. M140152).ConclusionGiven the nonspecific nature of presenting symptoms and signs and the fact that KS is the most common gastrointestinal malignancy in patients with AIDS, a high index of suspicion in at-risk patients may CASE REPORTHIV/AIDS-associated Kaposi’s sarcoma of the gastrointestinal tract: A pictorial spectrumN Patel,1 BA Hons, MA, MB BCh; P Naidoo,2 BPharm, MMedSc (Pharmacol), MB BCh; P Mosiane,3 MB ChB, FCPath (SA);  C Jann-Kruger,4 FCS (SA)1  Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa 2  Medical Affairs, AstraZeneca South African Region, Johannesburg, South Africa3  Department of Anatomical Pathology, National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa4  Department of Surgery, Edenvale General Hospital, Johannesburg, South AfricaCorresponding author: N Patel (niravpatel44@gmail.com)We briefly report two cases of HIV/AIDS-associated Kaposi’s sarcoma affecting the gastrointestinal tract. Both patients were seen at Edenvale General Hospital, Johannesburg, South Africa.S Afr Med J 2016;106(10):986-987. DOI:10.7196/SAMJ.2016.v106i10.11277Fig. 1. A and B. Stomach lesions of female patient.A BA BFig. 2. Male patient. A: Lesions in the colon. B: Strong nuclear staining for human herpesvirus B, 400× magnification.This open access article is distributed under Creative Commons licence CC-BY-NC 4.0.IN PRACTICE987       October 2016, Vol. 106, No. 10aid in the early diagnosis and management of this life-threatening disease.[1] Endoscopy is an effective means of early diagnosis and may allow for earlier initiation of HAART in asymptomatic patients.1. Weber JN, Carmichael DJ, Boylston A, Munro A, Whitear WP, Pinching AJ. Kaposi’s sarcoma of the bowel – presenting as apparent ulcerative colitis. Gut 1985;26(3):295-300.Accepted 19 July 2016.

HIV/AIDS-associated Kaposi’s sarcoma of the gastrointestinal tract: A pictorial spectrum

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HIV/AIDS-associated Kaposi’s sarcoma of the gastrointestinal tract: A pictorial spectrum

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