Drug-induced colonic Kaposi’s sarcoma in a HIV-negative patient with ulcerative colitis: a case report and review of the literature

Herculano, Rita; Barreiro, Pedro; Hann, Alexander; Chapim, Iolanda; Bispo, Miguel; Santos, Sofia; Monteiro, Lucília; Chagas, Cristina; Matos, Leopoldo

doi:10.1007/s00384-014-1912-0

Cited by 6 publications

(6 citation statements)

References 4 publications

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“…There are no specific staging systems or treatment guidelines for iatrogenic KS [ 1 ]. Present consensus suggests spontaneous remission of iatrogenic KS occurs after discontinuation of or a switch to another immunosuppressive therapy in patients who have undergone an organ transplant [ 1 , 3 , 4 , 7 , 11 ]. Unfortunately, withdrawal or a reduction in the dose of immunomodulators is difficult to implement in some situations (for example, in patients with IBD that frequently flares up).…”

Section: Discussionmentioning

confidence: 99%

“…By contrast, the average period of exposure to immunomodulators in the cases in the literature of patients with KS and IBD ranged from 1 to 2 years. A few cases of patients with ulcerative colitis reported administration of immunomodulators for just 1–3 months prior to the development of intestinal KS [ 3 , 5 ]. We believe that even short-term exposure to immunomodulators has the potential to induce KS.…”

Section: Discussionmentioning

confidence: 99%

“…Intestinal KS in patients with IBD following administration of immunomodulators is extremely rare [3][4][5]. We searched the Pubmed database using combinations of the terms "Crohn's disease, " "ulcerative colitis, " and "Kaposi sarcoma" and found only case reports on this issue.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with IBD usually require one or more immunomodulators if they are resistant to basic treatment. Intestinal KS following immunomodulation in patients with IBD [3][4][5][6] is a rare, iatrogenic complication. Furthermore, KS that occurs in the small intestine is extremely rare, especially as a result of the interaction between Crohn's disease and the use of immunomodulators.…”

Section: Introductionmentioning

confidence: 99%

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Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature

Sun

Kuo

et al. 2022

J Med Case Reports

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Background Kaposi sarcoma is a vascular tumor highly related to human herpesvirus-8 and Kaposi sarcoma–associated herpesvirus. Kaposi sarcoma usually manifests as skin or mucosal lesions; involvement in visceral organs such as the gastrointestinal tract is rare. Kaposi sarcoma can occur in immunocompromised patients receiving immunosuppressive therapy, in which case it is known as iatrogenic Kaposi sarcoma or drug-induced Kaposi sarcoma. Intestinal Kaposi sarcoma in patients with inflammatory bowel disease is extremely rare. Case presentation A 46-year-old East Asian male with recently diagnosed Crohn’s disease was administered azathioprine and prednisolone; however, the patient complained of persistent abdominal pain and diarrhea following treatment. Endoscopy revealed small bowel Kaposi sarcoma. The patient was treated with systemic chemotherapy successfully without relapse. Conclusions This is the fifth case of Kaposi sarcoma developed over the small intestine in a patient with Crohn’s disease following administration of immunomodulators. Additionally, this case indicated that even short-term immunomodulator use can induce Kaposi sarcoma in patients with inflammatory bowel disease. Thus, in patients with inflammatory bowel disease, if symptoms are aggravated or do not abate after immunomodulators prescription, and before intending to upgrade immunomodulators, endoscopy should be considered. Finally, chemotherapy can also be considered if both medication withdrawal and surgical intervention are not feasible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature

Sun

Kuo

et al. 2022

J Med Case Reports

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“…In most cases, iatrogenic KS appears in kidney-transplanted patients. However, it has also been reported in chronic inflammatory conditions that require immunosuppressive therapies for a long period such as UC [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] and CD [21][22][23][24]. In this scenario, the anti-TNF-α agents, the anti-integrin agent VDZ and, recently, the anti-interleukin (IL)-12/23 ustekinumab have been added to the IBD therapeutic armamentarium, which already included steroids and the traditional immunosuppressants (i.e., azathioprine, methotrexate, and cyclosporine).…”

Section: Discussionmentioning

confidence: 99%

Human herpesvirus 8-associated colonic Kaposi’s sarcoma during vedolizumab treatment in ulcerative colitis: a case report and review of the literature

et al. 2020

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Background: Kaposi's sarcoma (KS) is a rare vascular tumor associated with human herpesvirus (HHV)-8 infection.One of the variants of KS is defined iatrogenic and is overall reported in transplanted patient but also, although less frequently, in patients treated with long-standing immunosuppressive therapy, such as in inflammatory bowel disease including ulcerative colitis and Crohn's disease. Case presentation: Herein, we report the first case of KS in a human immunodeficiency virus (HIV)-negative 47year old male with UC after treatment with the α4-β7 integrin inhibitor vedolizumab (VDZ). The patient underwent to colectomy for a medical refractory disease and the histological examination of the surgical specimen showed the typical findings of KS together with the HHV-8 positivity. The patient achieved a good health status, without any sign of disease recurrence. Conclusions: In the present case, we can assume that VDZ may have promoted the reactivation of a latent HHV-8 infection endowed with oncogenic potentialities and, in turn, the onset of KS. We also briefly reviewed all the cases of KS in HIV-negative patients with inflammatory bowel disease.

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Drug-induced colonic Kaposi’s sarcoma in a HIV-negative patient with ulcerative colitis: a case report and review of the literature

Cited by 6 publications

References 4 publications

Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature

Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature

Human herpesvirus 8-associated colonic Kaposi’s sarcoma during vedolizumab treatment in ulcerative colitis: a case report and review of the literature

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