[Clinical manifestations and endoscopic characteristics of Kaposi's sarcoma in patients with acquired immunodeficiency syndrome].

BACKGROUND

Kaposi sarcoma may be the initial manifestation of immunodeficiency acquired syndrome (AIDS )in 30% of patients. The digestive tract is the thirth most affected site after the skin and lymph nodes.

OBJECTIVE

To correlate the clinic and endoscopic manifestations of patients with AIDS.

METHOD: 12 consecutive cases with AIDS and Kaposi sarcoma. We analyzed clinical data, positivity , immune state (leucocytes, lymphocytes, viral load, CD4 and CD8 counts, CD4/CD8 relation), opportunistic infections, tumors, endoscopic characteristics of the associated tumors, and histologic results.

RESULTS

12 patients. 11 men and 1 woman with an average age of 37.3 years old, a Karnofsky score X = 80%, weight X = 55.7 kg. All of them acquired the disease by sexual contact. The symptoms were weight loss in 6 cases, anemia in 6, abdominal pain 6, fever 6, melena 4, odynophagia 3, diarrhea 4, hematemesis 2, abdominal distention 2, dysphagia 2, bright red blood per rectum 1. The distribution of Kaposi sarcoma was as follows: hard palate 7, soft palate 2, larynx 3, esophagus 2, stomach 10, duodenum 2, colon 5 and anal conduct 1. The endoscopic appearance was in the majority a purple or blue elevated plaque that had various sizes. The biopsy was positive to Kaposi sarcoma in at least one lesion of each patient. The haemoglobin was x = 11.5, leukocytes X = 5463, total lymphocytes X = 2377 (35.7%), CD4 X = 247.8 (10.8%), CD8 X = 1008.7 (54.6%). CD4/CD8 relation = 0.20, T4/T8 = 0.25M, the viral load was X = 140,629 copies.

CONCLUSIONS

The Kaposi sarcoma appears as a multiple lesion with diverse aspect and colors that go from purple to blue or red. There is correlation between a high number of Kaposi sarcoma lesions, affected organs, immunologic status and mortality.