Life-threatening Gastrointestinal Bleeding Secondary to Kaposi’s Sarcoma of the Duodenum

Ibrahim, Hanan; Ghanimeh, Mouhanna Abu; Al-Saheli, Zaid I; Naffouj, Sandra

doi:10.7759/cureus.7322

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…In addition to the psychosocial barriers and stigma that this population faces, PWH and cancer are significantly less likely to be offered appropriate cancer treatment [22], making them susceptible to severe disease manifestations requiring ICU-level care. However, little is known about the admissions and outcomes of patients with KADs who require ICU-level care in the current ARTera, as existing literature is largely limited to case reports [23,24]. As patients with symptomatic KADs and HIV can deteriorate rapidly requiring ICU admission, better characterization is needed for optimal, equitable care of these patients.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of patients admitted to the ICU with Kaposi sarcoma herpesvirus-associated diseases

Hansen

Mangusan

Lurain

et al. 2022

Aids

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Objective: There are four conditions caused by Kaposi sarcoma herpesvirus (KSHV): Kaposi sarcoma, KSHV-associated multicentric Castleman disease (MCD), primary effusion lymphoma (PEL), and KSHV inflammatory cytokine syndrome (KICS). These KSHV-associated disorders (KADs) often occur in people with HIV and can lead to multiorgan dysfunction requiring admission to the ICU. However, little is known about patient outcomes in this setting.Methods: A retrospective study of patients with KADs admitted to the ICU between 2010 and 2021 was conducted, examining KAD admission diagnoses, HIV characteristics, selected cytokine profiles, and ICU interventions. Primary outcomes were 60-day and median overall survival from ICU admission to death from any cause.Results: Forty-seven patients (all but one with HIV coinfection) were included. At ICU admission, 44 patients (94%) were on antiretroviral therapy with a median CD4 þ count of 88 cells/ml and HIV viral load of 23 copies/ml. The most common presentation was respiratory failure alone (19%) or with hypotension (17%). Twenty-two (47%) patients had presumed KICS (with or without Kaposi sarcoma) at admission and an additional KAD was diagnosed in 36% of these patients. IL-6 levels did not vary across KAD subtype. Twenty (43%) patients received KAD-directed therapy in the ICU. Sixty-day survival was 70% and median overall survival was 9 months. Conclusion:The majority of patients with HIV and KADs admitted to the ICU had well controlled HIV. Additional KAD were diagnosed during ICU admission in a proportion of patients who presented with presumed KICS. Critical illness did not preclude a subset of patients from receiving KAD-directed therapy in the ICU.

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Section: Introductionmentioning

confidence: 99%