The appearance of kaposi sarcoma during corticosteroid therapy

Abstract

Background. Four epidemiologic types of Kaposi sarcoma (KS) are known: classic KS, endemic African KS, epidemic or acquired immunodeficiency syndrome–related KS, and KS associated with immunosuppressive therapy. In most of the latter patients, KS was reported to have developed after organ transplantation, particularly renal transplantation. Thirty‐nine patients who have not had a transplant have been reported to have KS associated with corticosteroid therapy. Methods. The authors studied 10 patients with the appearance of KS during corticosteroid therapy (6 men, 4 women; age range, 42–79 years) who were treated with corticosteroids for autoimmune disorders (5 patients), lymphoproliferative disorders (2 patients), and diseases unrelated to the immune system (3 patients). Results. Genetically programmed susceptibility to corticosteroid‐related KS was suggested by the descent of the study patients as well as most of those reported previously. The prognosis was guarded in all the study patients. Conclusions. Corticosteroids should be withdrawn to achieve clinical remission.

Kaposi's sarcoma-associated herpesvirus-encoded LANA associates with glucocorticoid receptor and enhances its transcriptional activities

“…After DEX stimulation, GRE-LUC activity was significantly enhanced and DG75 cell viability was decreased by LANA binding to GR. Some reports indicate that the incidence of KS is clinically increased by GCs [20][21][22][23][24][25][26][27]. The involvement of GR-mediated signals in KSHV-related malignancies will clarify the significance of LANA/GR interactions.…”

“…KSHV reactivation is also induced by certain stimuli such as viral co-infection as well as hypo-and hyper-oxidative responses [1,4]. Several reports indicate the involvement of GCs in KSHV reactivation [20][21][22][23][24][25][26][27]. GC treatment induces lytic viral gene expression in some, but not all, KSHV-infected B-lymphocyte lines.…”

“…However, many clinical data suggest that GCs may increase the incidence of KS in organ transplant recipients or exacerbate existing KS lesions [20][21][22][23][24][25][26][27]. It remains controversial whether GCs induce lytic viral gene expression in latently infected cells [22,28], and the mechanisms underlying the clinical effects of GCs in KS are poorly understood despite their importance.…”

Kaposi Sarcoma after Corticosteroid Therapy for Idiopathic Thrombocytopenic Purpura

“…KS has been reported less frequently during immunosuppressive therapy for a variety of clinical disorders such as rheumatologic disease, hematologic disease and pulmonary disease. More recently, corticosteroid therapy has been associated with the development of KS 5 . Therefore, corticosteroid induced immunosuppression appears to constitutes a risk factor for the development of KS.…”

“…Indeed, we found three reported cases similar to our case (Table 1) [9][10][11] . The interval between the initiation of steroid therapy and the development of KS has been reported as 3 to 36 months, the average being 13.7 months 5 . In our case, the interval was two months, which was shorter than that previously reported.…”