Gastrointestinal Kaposi sarcoma

Excerpt

A 25-year-old male with acquired immunodeficiency syndrome (AIDS) presented to the emergency department with severe abdominal pain and hematochezia. Laboratory evaluation revealed a high human immunodeficiency virus (HIV) count of 327,997 copies/ml, CD4 count of 40 cells/mm³, and pancytopenia. Computed tomography of his abdomen revealed pancolitis, and intravenous antibiotics was  started. During his hospitalization, he required platelet and blood transfusions. After resolution of neutropenia, he underwent flexible sigmoidoscopy that revealed multiple annular red purple lesions throughout the rectosigmoid (Fig. 1). Biopsies showed intramucosal hemorrhage (Fig. 2), immunohistochemistry was positive for human herpesvirus 8 (HHV-8), and a marker for lymphatic endothelium podoplanin (D2-40) (Fig. 2) consistent with Kaposi sarcoma (KS) [1]. He was started on antiretroviral therapy and discharged after monitoring for immune reconstitution inflammatory syndrome. Four weeks later, his hematochezia resolved and his CD4 count increased to 151 cells/mm³.

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