Idiopathic giant esophageal ulcer in an HIV-positive child

Abstract

We report a 3-year old HIV-positive female with a 2-cm deep ulcer in the mid-esophagus. A presumptive diagnosis of idiopathic giant ulcer was made after infectious pathogens had been excluded. The child was successfully treated with steroids. Although infectious causes of giant esophageal ulcers in HIV-positive children are common, the diagnosis of idiopathic giant ulcer must be considered in order to institute proper therapy.

The utility of upper digestive endoscopy in the evaluation of HIV patients with low CD4+ T-lymphocyte values

“…The disruption of the epithelial barrier leads to the exposure of the underlying tissues to a multitude of antigens in the intestinal lumen, some of them with pro-inflammatory potential. As the disease progresses, bacterial translocation and inflammatory process are spreading and generalizing, with moderate effects due to the prompt initiation of antiretroviral therapy 12,13 . Indirect evidence of intestinal epithelial barrier disruption, bacterial translocation and inflammatory processes comes from studies which demonstrated an increased plasma concentration of substances associated with these processes, such as lipopolysaccharide (LPS), CD14s (LPS co-receptor), intestinal fatty-acid binding protein (I-FABP) (biomarker of apoptosis in intestinal epithelial cells) and the decrease of others, such as zonulin 14 .…”

Gastrointestinal Complications of Secondary Immunodeficiency Syndromes

“…Idiopathic oral and esophageal ulcers have been described in both children and adults with HIV-1. 133 These ulcers are characteristically large and may be single or multiple in nature ( Fig. 39.5).…”

Gastrointestinal complications of secondary immunodeficiency syndromes

“…133 These ulcers are characteristically large and may be single or multiple in nature (Fig. Idiopathic oral and esophageal ulcers have been described in both children and adults with HIV-1.…”