HIV and achalasia

Barrow, Peter; Mahomed, Adam; Karlsson, Kay

doi:10.1097/01.aids.0000186820.22865.ce

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…One study reported two HIV-positive achalasia patients with no opportunistic infection of the esophagus. 70 Another study described a case of AIDS with achalasia whose esophageal symptoms were ameliorated only after having been treated with both antiretroviral and anti-tuberculosis agents. 71 Considering that it has been confirmed as a neurotrophic virus that can lead to the loss of autonomic nerves, HIV may cause achalasia both through the neurotrophic way and by opportunistic infectious agents.…”

Section: Human Immunodeficiency Virusmentioning

confidence: 99%

The etiology of achalasia: An immune‐dominant disease

Liu

Wang

et al. 2021

J of Digest Diseases

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There is accumulating evidence suggesting that an autoimmune component is involved in esophageal achalasia. An increase in immune cells, cytokines, chemokines, and autoimmune antibodies in serum and infiltration of immune cells in tissues support the view that immune-mediated inflammation is a crucial pathogenesis of inhibitory neuron degeneration in the lower esophageal sphincter. Infection of viruses such as the herpes virus family has been suspected of provoking the autoimmune reaction. Meanwhile, previous reports on immunogenetics have proposed that specific risk alleles on the human leukocyte antigen complex define the susceptible population to achalasia. In this study we reviewed current knowledge regarding the immune-related factors of achalasia, including immunology, viral infection and immunogenetic variations. K E Y W O R D S autoimmune diseases, esophageal achalasia, histocompatibility antigens class II, immunology, viruses 1 | INTRODUCTION Esophageal achalasia is a motility disorder that presents with symptoms including dysphagia, regurgitation, chest pain, and weight loss. It is clinically subclassified into three types based on different manifestations in high-resolution manometry: type I achalasia is the classical achalasia with no pressurization; in type II achalasia there is compression of over 30 mmHg in the distal esophagus; while type III achalasia can be diagnosed when two or more spastic contractions are observed. 1 The pathophysiology of this disease is a loss of peristalsis and inadequate relaxation of the lower esophageal sphincter (LES), which results from gradual disappearance of the myenteric neurons. Previous histological studies have found the loss of inhibitory enteric neurons in the esophageal tissues of patients with achalasia. 2 In the nervous system, these types of neurons contain nitric oxide and vasoactive intestinal polypeptide, which are responsible for this process. 7 Achalasia was recognized as a degenerative disease of the myenteric plexus. 8 About three decades ago studies on achalasia revealed inflammatory cell infiltration in the myenteric ganglia. 9 Later reports have demonstrated that the pathogenesis of achalasia is associated with immunology, viral infection, and host genetics. It turns out that immunology is potentially the crucial factor, and viral infection may trigger the disordered immune reaction in specific patients with an immunogenetic variation. In this review, we focused on all the *These three authors contributed equally to this work.

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Section: Human Immunodeficiency Virusmentioning

confidence: 99%

The etiology of achalasia: An immune‐dominant disease

Liu

Wang

et al. 2021

J of Digest Diseases

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“…[2][3][4] The etiology of the pseudoachalasia in the patient described in the current report is a classic obstructive phenomenon by tumor mass. Although not a true disorder of esophageal motor function, it is often classified with such, because its presenting manifestations are commonly dysphagia, regurgitation, and weight loss.…”

Section: Diagnosis In Oncologymentioning

confidence: 74%

Retroperitoneal Diffuse Large B-Cell Lymphoma Presenting As Pseudoachalasia

Pastor

Eggers

Loughran

et al. 2010

JCO

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“…Barrow et al . reported two cases of achalasia diagnosed in HIV‐positive patients without any opportunistic infection of the esophagus.…”

Section: Discussionmentioning

confidence: 99%

“…It can be a primary esophageal motor disorder, also known as idiopathic or primary achalasia, or secondary to malignancies, post‐fundoplication and infectious diseases. Although there are isolated case reports of patients presenting with acquired immune deficiency syndrome (AIDS) and secondary achalasia, the causal effect between them is hard to be established . It is commonly believed that achalasia is secondary to the opportunistic infection of AIDS.…”

Section: Introductionmentioning

confidence: 99%