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M94A3020.TXT
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1994-10-25
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Document 3020
DOCN M94A3020
TI Protein-losing enteropathy developing in an AIDS patient with duodenal
Kaposi's sarcoma.
DT 9412
AU Takechi A; Masuda G; Ajisawa A; Negishi M; Yamaguchi T; Yamada Y; Fujii
H; Tokyo Metropolitan Komagome Hospital.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):171 (abstract no. PB0109). Unique
Identifier : AIDSLINE ICA10/94369555
AB A Japanese homosexual, HIV-positive man aged in his 30s was admitted to
Tokyo Metropolitan Komagome Hospital in the fall of 1992. He had been
presenting with Kaposi's sarcoma (KS) persisting over his body surface a
year before the admission. His general condition was good. Blood data
included: WBCs 7,000/microliters; CD4+cells 59/microliters; total
protein 4.5 g/dl; albumin 1.8 g/dl; and his liver enzyme values were
normal. Serum total protein and albumin progressively decreased, and he
returned with pitting edema and bilateral transudative pleural effusion.
Albuminuria was not demonstrated. Despite repeated IV administration of
human albumin, his serum protein level remained low. Upper GI tract
endoscopy demonstrated multiple small polypoid lesions in the 2nd and
3rd parts of the duodenum. They were reddish and sessile. Biopsied
specimens of the lesions revealed KS with villous atrophy and lymphatic
dilatation. With the use of 99mTc -HSA-D (human serum albumin)
scintigraphy, protein loss from the site of duodenal KS was established.
Stool specimens were negative for occult blood, ova, parasites and
pathogenic bacteria. After obtaining his informed consent, radiotherapy
with a total of 30 Gy was performed. Two months later, his general
condition became improved requiring no further albumin replacement.
Follow-up 99mTc-HSA-D studies indicated a decreased loss of albumin into
the duodenal lumen. Endoscopic and roentgenologic studies also
demonstrated improved duodenal KS. The patient eventually died of
cryptococcal meningitis ten months after his admission to our hospital.
DE Adult Case Report Diagnosis, Differential Duodenal
Neoplasms/*COMPLICATIONS/RADIONUCLIDE IMAGING/ RADIOTHERAPY Follow-Up
Studies Human HIV Seropositivity/*COMPLICATIONS/RADIONUCLIDE IMAGING
Japan Male Protein-Losing Enteropathies/*ETIOLOGY/RADIONUCLIDE
IMAGING/ RADIOTHERAPY Radiotherapy Dosage Sarcoma,
Kaposi's/*COMPLICATIONS/RADIONUCLIDE IMAGING/ RADIOTHERAPY MEETING
ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).