Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Esophageal disease is a common cause of morbidity in patients infected by human immunodeficiency virus (HIV). Although gastrointestinal involvement of leishmaniasis has been previously reported, we believed that we describe the first case of leishmania esophagitis. Clinical data and the endoscopic and histologic hallmarks are described.
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PMID:Leishmania esophagitis in an AIDS patient: an unusual form of visceral leishmaniasis. 830 17

Twenty-five patients with AIDS and esophageal symptoms were evaluated for the presence of esophageal disease and human immunodeficiency virus type 1 (HIV-1) in the esophageal mucosa. A single infectious process caused by Candida albicans, cytomegalovirus, herpes simplex virus, varicella-zoster virus, or Mycobacterium avium-intracellulare complex or a single noninfectious process caused by Kaposi's sarcoma or reflux esophagitis was identified in 20 patients. Two processes were identified in 5 patients. HIV-1 mRNA was detected by in situ hybridization in mononuclear cells in esophageal lamina propria in 36% of patients. The presence of HIV-1 in the esophageal mucosa was not associated with a specific esophageal symptom, mucosal inflammation or ulceration, Kaposi's sarcoma, specific opportunistic infection, or response of the infection(s) to therapy. Esophageal disease in patients with AIDS appears to be associated with specific pathologic processes rather than the presence of HIV-1 in esophageal mucosa.
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PMID:Esophageal disease in AIDS is associated with pathologic processes rather than mucosal human immunodeficiency virus type 1. 826 81

Idiopathic esophageal ulcerations (IEUs) associated with human immunodeficiency virus (HIV) infection are now recognized as an important cause of esophageal disease in this population. Limited radiographic and endoscopic reports have almost uniformly described these lesions as solitary and giant. Over a 28-month period, we identified 68 IEUs endoscopically in 23 patients. Most patients had long-standing HIV infection and a low CD4(+) lymphocyte count. Multiple ulcers were identified in 57% of endoscopies. Giant ulcers were seen in one-third, with 37% < or = 1 cm in greatest dimension. Most of the lesions were in the mild- to distal esophagus. The ulcers were characterized as either shallow or intermediate in depth in 53%, with a deep ulcer in 7%. A "heaped-up" appearance of the ulcer was identified in 40%. An esophageal mucosal bridge(s) was seen in two patients. In contrast to previous reports, IEUs are variable endoscopically in number, size, and appearance. Given this lack of uniformity in appearance, which may mimic other causes of esophageal ulceration, all HIV-infected patients with an esophageal ulceration should undergo endoscopy with biopsy to obtain a definitive diagnosis.
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PMID:Endoscopic characterization of idiopathic esophageal ulceration associated with human immunodeficiency virus infection. 850 1

Idiopathic esophageal ulcerations (IEUs) associated with human immunodeficiency virus (HIV) infection are now recognized as an important cause of esophageal disease in this population. We report one case of IEU complicated with a fistula to the bronchial tree. Given his variable appearance, which may mimic other causes of esophageal ulceration and the high response rate to oral corticosteroid therapy, all HIV infected patients with esophageal ulceration should undergo endoscopy with biopsy to obtain a definitive diagnosis. We review the literature about the etiology, pathogenesis, management and treatment of the IEU.
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PMID:[Idiopathic esophageal ulcer with fistulization to the bronchial tree in a HIV-positive patient]. 866 69

Esophageal disease is a common and important cause of morbidity and mortality in patients with human immunodeficiency virus (HIV) infection. The etiology of HIV-related esophageal ulceration varies. After all known etiologies are excluded, a subgroup of patients remains with esophageal ulceration known as idiopathic esophageal ulceration (IEU). Establishing a diagnosis of IEU is critical and precludes unnecessary treatment with antiviral, antifungal, or antibiotic agents. A review of the current literature indicates that there are no prospective, placebo-controlled, randomized, double-blind trials on the specific treatment of IEU. Several preliminary reports suggest that corticosteroids and thalidomide may be effective. The incidence and natural history of IEU are incompletely known. It is important to establish that any potential therapeutic agents employed to treat IEU do not increase viral replication or provide viral protection. There is a need for well-designed, placebo-controlled, prospective studies to assess the risks and benefits of corticosteroids, thalidomide, and other agents in the treatment of idiopathic esophageal ulceration.
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PMID:Idiopathic esophageal ulceration in patients infected with human immunodeficiency virus. 893 35

A 61-year-old man with acquired immunodeficiency syndrome (AIDS) sought care because of the onset of progressive dysphagia. He was found to have a perforated, fungating esophageal mass. The combined histologic and immunologic findings were diagnostic of Hodgkin's disease, nodular sclerosis type, lymphocyte-depleted variant, arising in the esophagus. The Reed-Sternberg cells and mononuclear variants were positive for Epstein-Barr virus (EBV) latent membrane protein (LMP1) and EBV RNA. Occasional small lymphoid cells were also positive for EBV RNA. Polymerase chain reaction studies demonstrated the presence of EBV type A without deletion of the EBV LMP1 gene. Other authors have reported an increased frequency of type B EBV and deletion of the EBV LMP1 gene in cases of human immunodeficiency virus-associated Hodgkin's disease. Hodgkin's disease arising in the esophagus is rare in immunocompetent patients. However, in the presence of AIDS, Hodgkin's disease should be considered in the differential diagnosis of patients with signs or symptoms of esophageal disease.
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PMID:Hodgkin's disease of the esophagus. 935

The esophagus is one of the most common sites of gastrointestinal involvement in human immunodeficiency virus (HIV)-infected patients, with at least 30% of the patients having esophageal symptoms at some point during the course of HIV infection. Esophageal ulcers are commonly caused by infections such as cytomegalovirus (CMV) or may be idiopathic. The clinical presentation of the various causes of esophageal ulcers are similar; therefore, a thorough endoscopic and histological workup is imperative to make a diagnosis and, consequently, to provide appropriate therapy. The widespread use of more effective antiretroviral therapy appears to have led to a decline in gastrointestinal opportunistic disorders in patients with acquired immunodeficiency syndrome (AIDS), including those involving the esophagus. Unfortunately, there are several reports of resistance of HIV-1 to multiple antiretroviral agents, and thus it is possible we will observe an increase in various opportunistic disorders again. The aim of this article is to provide a practical approach to the clinical, endoscopic, and histopathologic evaluation of esophageal ulcers in patients with AIDS.
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PMID:Diagnosis of esophageal ulcers in acquired immunodeficiency syndrome. 1043 95

Candida oesophagitis is an acquired immune deficiency syndrome (AIDS)-defining illness. We report a 28-year-old woman who presented with Candida oesophagitis with underlying chronic hepatitis C. The patient presented with anorexia and weakness and was noted to have raised serum transaminases. Upper-gastrointestinal endoscopy revealed Candida oesophagitis involving the whole oesophagus. Oesophageal biopsy demonstrated changes consistent with Candida oesophagitis. Serology was positive for hepatitis C antibodies, and polymerase chain reaction (PCR) genotyped hepatitis C virus (HCV) as genotype 3. Liver biopsy revealed chronic hepatitis with moderately active portal inflammation. A human immunodeficiency virus (HIV) test was non-reactive for types 1 and 2. The development of Candida oesophagitis in a patient with chronic HCV infection demands prompt consideration of general debility and immunosuppression as effects of HCV that led to an occurrence of opportunistic infection. Evaluation of this case provides insight into various mechanisms of immune suppression associated with HCV infection.
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PMID:Candida oesophagitis with hepatitis C virus: an uncommon association. 1284 Jun 84

Esophageal disease is a common complication and cause of morbidity in patients with human immunodeficiency virus (HIV) infection. Opportunistic infections are the leading cause of esophageal complaints and may be a predictor of poor long-term prognosis, presumably as a reflection of severe underlying HIV immunodeficiency. The esophagus may be the site of the first acquired immunodeficiency syndrome (AIDS)-defining opportunistic illness in a large number of patients. Barium esophagography and upper gastrointestinal endoscopy are diagnostic modalities, commonly used to evaluate esophageal complaints in patients with AIDS. Treatment for most etiologies of esophagitis generally has a high degree of success, with a resultant improvement in quality of life. In addition to optimizing antiretroviral therapy, a thorough diagnostic assessment of every HIV-infected patient with esophageal complaints is warranted, followed by timely and appropriate treatment.
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PMID:Diagnosis and management of infectious esophagitis associated with human immunodeficiency virus infection. 1294 77

Esophageal ulcers are a rare cause of upper gastrointestinal bleeding. This report describes the etiology, treatment, complications, and outcome of esophageal ulcers. An esophageal ulcer is defined as a discrete break in the esophageal mucosa with a clearly circumscribed margin; esophageal ulcers were seen in 88 patients from a total of 7,564 esophagogastroduodenoscopies done by one surgeon at an urban hospital from 1991 to 2001. All hospital reports were reviewed. The etiology of esophageal ulcers included the following: gastrointestinal reflux disease (GERD) (n=58, 65.9%), drug induced (n=20, 22.7%), candidal (n=3, 3.4%), caustic injury (n=2, 2.3%), and herpes simplex virus (HSV), human immunodeficiency virus (HIV), marginal ulcer, foreign body, and unknown etiology (n=1 of each, 1.1%). The mean size of GERD-induced esophageal ulcers and drug-induced esophageal ulcers was 2.78 and 2.92 cm, respectively; 80.3% of GERD-induced esophageal ulcers and 13.8% of drug-induced esophageal ulcers were located in the lower thoracic esophagus. Morbidity (n=44, 50%) included hemorrhage (n=30, 34%), esophageal stricture (n=11, 12.5%), and esophageal perforation (n=3, 3.4%). Nonoperative therapy sufficed in 81 patients (92%). Three patients (3.4%) had a recurrence of esophageal ulcers. Fifteen patients (17.0%) required endoscopic intervention including esophageal dilatation for stricture in 11 patients and endoscopic hemostasis for esophageal bleeding in four patients. Surgery (n=7, 8.0%) was reserved for esophageal stricture and perforation. Two patients (2.3%) died from complications of esophageal ulcers: hemorrhage in one and perforation in one. Three patients died of their primary disease. GERD and drug ingestion are common causes of esophageal ulcers. Midesophageal ulcers have a greater tendency to hemorrhage compared with ulcers at the gastroesophageal junction; this may reflect the etiology. Strictures complicate GERD-induced esophageal ulcers but not drug-induced esophageal ulcers. Esophageal dilatation is an effective treatment for most strictures associated with esophageal ulcers. Esophageal ulcers rarely cause death.
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PMID:Etiology, treatment, and outcome of esophageal ulcers: a 10-year experience in an urban emergency hospital. 1459 55


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