Sclerosing cholangitis in acquired immunodeficiency syndrome. Case reports and review of the literature.

Abstract:

:Four patients with acquired immunodeficiency syndrome (AIDS) (CDC group IV) were investigated for biliary disease because of the presence of both severe upper abdominal pain and raised levels of serum alkaline phosphatase. None was clinically jaundiced. Upper abdominal ultrasound was abnormal in three. All had endoscopic retrograde cholangiographic evidence of both an intrahepatic sclerosing cholangitis suggestive of primary sclerosing cholangitis and an irregular suprapapillary common bile duct dilation suggestive of papillary stenosis. Three had evidence of gastrointestinal cryptosporidiosis and two of disseminated cytomegalovirus infection. Endoscopic sphincterotomy, performed in two patients, gave good pain relief. We propose the name 'AIDS sclerosing cholangitis' for this form of secondary cholangitis. The cause of this disorder remains unclear. Recent evidence is discussed which suggests that it is not due to HIV itself but to an opportunistic infection. Cryptosporidium appears to be the most likely candidate.

journal_name

Scand J Gastroenterol

authors

Dowsett JF,Miller R,Davidson R,Vaira D,Polydorou A,Cairns SR,Weller IV

doi

10.3109/00365528809090203

subject

Has Abstract

pub_date

1988-12-01 00:00:00

pages

1267-74

issue

10

eissn

0036-5521

issn

1502-7708

journal_volume

23

pub_type

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