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

Abstract

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.

Concurrence of talaromycosis and Kaposi sarcoma in a HIV-infected Patient: A case report

“…Diagnosis of Kaposi sarcoma mainly relies on clinical manifestations and histopathological examination. Radiographic characteristics of pulmonary Kaposi sarcoma are non-speci c, often presented as nodules, pleural effusions, hilar or mediatinal lymphadenopathy, and patchy shadows [9]. In this case, the patient's chest CT showed multiple nodules and in ltrates in the bilateral lungs, in combination with purple rashes in his feet and violaceous plaques in the oral cavity, suggesting a possibility of Kaposi sarcoma, that was subsequentially con rmed by histopathological analysis of skin biopsies.…”

Concurrence of Talaromycosis and Kaposi Sarcoma in an HIV-Infected Patient: A Case Report

“…Kaposi sarcoma is a malignant vascular tumor frequently found in HIV-infected patients [1] and has been linked to human gammaherpesvirus 8 [9]. Diagnosis of Kaposi sarcoma mainly relies on clinical manifestations and histopathological examination.…”

Das Kaposi-Sarkom – eine Komplikation bei therapierefraktärer Colitis ulcerosa

“…Hierüber wird die Bindung der Lymphozyten an MAdCAM-Rezeptoren auf dem Endothel von intestinalen Blutgefäßen und deren konsekutive Einwanderung in das Gewebe verhindert, die Entzündungsreaktion supprimiert“ 3 45 47 30 w m m Nein Ja Nein Papa V et al. 2020 [ 12 ] Ajao SO 2021 [ 2 ] Fischer et al. 2022 [ 17 ] Prednisolon Kortikosteroide Bindung des intrazellulären Glukokortikoidrezeptors, der in den Zellkern transloziert wird.…”

“…In der englischsprachigen Literatur wird zunehmend über HIV-negative gastrointestinale Kaposi-Sarkome bei therapierefraktärer Colitis ulcerosa berichtet. Einschließlich der eigenen Beobachtung wurden unseres Wissens nach insgesamt 30 Fälle publiziert [ 4 , 8 , 10 , 12 ]. Bei unterschiedlichen autoimmunen Grunderkrankungen, so bei Colitis ulcerosa, Morbus Crohn, rheumatoider Arthritis, Psoriasis oder Psoriasisarthritis scheint die Therapie mit einer Reihe von Immunsuppressiva oder Immunmodulatoren als seltene Komplikation die Entstehung eines Kaposi-Sarkoms zu begünstigen.…”