{"id":6130,"date":"2019-09-13T11:36:22","date_gmt":"2019-09-13T09:36:22","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/bildergalerie\/intestinales-kaposi-sarkom\/"},"modified":"2019-10-08T10:35:01","modified_gmt":"2019-10-08T08:35:01","slug":"intestinal-kaposi-sarcoma","status":"publish","type":"bildergalerie","link":"https:\/\/www.endoscopy-campus.com\/en\/bildergalerie\/intestinal-kaposi-sarcoma\/","title":{"rendered":"Intestinal Kaposi sarcoma"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Patient history and clinical findings<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A 38-year-old man in a clearly impaired general state of health presented for clarification of Hb-relevant gastrointestinal bleeding with melena and transfusion-refractory thrombopenia. With an initial diagnosis of HIV infection (CDC stage C3), the patient was already receiving HIV medication with Truvada (emtricitabine\/tenofovir) and Tivicay (dolutegravir), as well as Norvir (ritonavir) and Prezista (darunavir), with a severe clinical course.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Laboratory diagnosis (at the time of examination)<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline;\">Clinical chemistry:<\/span><br>Leukocytes 6.2 G\/L, hemoglobin 6.2 g\/dL, thrombocytes 2 G\/L<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline;\">Virology:<\/span><br>HIV-1-RNA quantitative 840,000 GE\/mL (no resistance mutation)<br>HHV -8 DNA positive 1e+07 GE\/mL<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Endoscopy<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">At the emergency gastroscopy that was carried out, multiple bright red polypoid lesions were noted in both the stomach and duodenum. These were biopsied for further clarification.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Incidental findings included a large axial hernia, grade A reflux esophagitis, mucosal erythema in the gastric body and antrum, fibrin-covered raised erosions in the duodenum, and mucosal erythema in the duodenal bulb.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Colonoscopy did not show any evidence of active lower gastrointestinal bleeding. Here again, multiple bright red polypoid lesions were noted.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Diffuse mucosal bleeding with treatment-refractory thrombopenia was regarded as the probable source of bleeding.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Images<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">1. Gastroscopy: <\/h3>\n\n\n\n<ul class=\"wp-block-gallery columns-2 is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\"><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"901\" height=\"507\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-2.jpeg\" alt=\"\" data-id=\"6122\" data-link=\"https:\/\/www.endoscopy-campus.com\/?attachment_id=6122\" class=\"wp-image-6122\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-2.jpeg 901w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-2-768x432.jpeg 768w\" sizes=\"auto, (max-width: 901px) 100vw, 901px\" \/><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"899\" height=\"507\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-1.jpeg\" alt=\"\" data-id=\"6120\" data-link=\"https:\/\/www.endoscopy-campus.com\/?attachment_id=6120\" class=\"wp-image-6120\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-1.jpeg 899w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-1-768x433.jpeg 768w\" sizes=\"auto, (max-width: 899px) 100vw, 899px\" \/><\/figure><\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">2. Colonoscopy: <\/h3>\n\n\n\n<ul class=\"wp-block-gallery columns-2 is-cropped wp-block-gallery-2 is-layout-flex wp-block-gallery-is-layout-flex\"><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"906\" height=\"510\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-4.jpeg\" alt=\"\" data-id=\"6126\" data-link=\"https:\/\/www.endoscopy-campus.com\/?attachment_id=6126\" class=\"wp-image-6126\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-4.jpeg 906w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-4-768x432.jpeg 768w\" sizes=\"auto, (max-width: 906px) 100vw, 906px\" \/><\/figure><\/li><li class=\"blocks-gallery-item\"><figure><img loading=\"lazy\" decoding=\"async\" width=\"906\" height=\"509\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-3.jpeg\" alt=\"\" data-id=\"6124\" data-link=\"https:\/\/www.endoscopy-campus.com\/?attachment_id=6124\" class=\"wp-image-6124\" srcset=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-3.jpeg 906w, https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Intestinales-Kaposi-Sarkom-3-768x431.jpeg 768w\" sizes=\"auto, (max-width: 906px) 100vw, 906px\" \/><\/figure><\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Pathology findings<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline;\">Macroscopy:<\/span><br>Two biopsy samples from the distal duodenal bulb. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline;\">Epicritic report:<\/span><br>Overall, the case involved duodenal mucosa with proliferations of CD31-positive, D2-40-positive cell formations and individual cells that were HHV8-positive on immune histology. CD34-negative. PCR analysis showed evidence of HHV8 DNA. With this pattern of findings, it must be assumed that it is a case of Kaposi sarcoma with an unusual CD34-negative immune phenotype.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Clinical course<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">After diagnostic confirmation of Kaposi sarcoma in the gastrointestinal tract and skin, this patient \u2014 with treatment-refractory thrombopenia, dialysis-dependent renal failure, and diffuse Hb-relevant mucosal bleeding, with suspected Kaposi sarcoma inflammatory cytokine syndrome \u2014 received treatment with rituximab. The treatment led to a slow increase in thrombocytes and improvement in renal function.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A 38-year-old man in a clearly impaired general state of health presented for clarification of Hb-relevant gastrointestinal bleeding with melena and transfusion-refractory thrombopenia. <\/p>\n","protected":false},"featured_media":6119,"template":"","categories":[97,171],"tags":[1780,1782,1785,1783,1786,1784],"ec-magazin-ausgaben":[1801],"sponsoren-erwaehnung":[],"autor":[],"class_list":["post-6130","bildergalerie","type-bildergalerie","status-publish","has-post-thumbnail","hentry","category-literature","category-special-cases","tag-hiv","tag-hiv-en","tag-kaposi-sarcoma","tag-kaposi-sarkom-en","tag-thrombopenia","tag-thrombopenie-en","ec-magazin-ausgaben-ec-magazine-2019-03"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/bildergalerie\/6130","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/bildergalerie"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/bildergalerie"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media\/6119"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=6130"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=6130"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=6130"},{"taxonomy":"ec-magazin-ausgaben","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-magazin-ausgaben?post=6130"},{"taxonomy":"sponsoren-erwaehnung","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/sponsoren-erwaehnung?post=6130"},{"taxonomy":"autor","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/autor?post=6130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}