Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature
Abstract Background Kaposi sarcoma is a vascular tumor highly related to human herpesvirus-8 and Kaposi sarcoma–associated herpesvirus. Kaposi sarcoma usually manifests as skin or mucosal lesions; involvement in visceral organs such as the gastrointestinal tract is rare. Kaposi sarcoma can occur in...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13256-022-03637-8 |
| _version_ | 1817970833816027136 |
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| author | Pei-Jui Wu Chi-Shu Sun Hsing-Tao Kuo Ming-Jen Sheu Cheng-Yi Lin Su-Hung Wang Chun-Chi Yang Chi‐Hsing Chen Shih-Sung Chuang I-Che Feng |
| author_facet | Pei-Jui Wu Chi-Shu Sun Hsing-Tao Kuo Ming-Jen Sheu Cheng-Yi Lin Su-Hung Wang Chun-Chi Yang Chi‐Hsing Chen Shih-Sung Chuang I-Che Feng |
| author_sort | Pei-Jui Wu |
| collection | DOAJ |
| description | Abstract Background Kaposi sarcoma is a vascular tumor highly related to human herpesvirus-8 and Kaposi sarcoma–associated herpesvirus. Kaposi sarcoma usually manifests as skin or mucosal lesions; involvement in visceral organs such as the gastrointestinal tract is rare. Kaposi sarcoma can occur in immunocompromised patients receiving immunosuppressive therapy, in which case it is known as iatrogenic Kaposi sarcoma or drug-induced Kaposi sarcoma. Intestinal Kaposi sarcoma in patients with inflammatory bowel disease is extremely rare. Case presentation A 46-year-old East Asian male with recently diagnosed Crohn’s disease was administered azathioprine and prednisolone; however, the patient complained of persistent abdominal pain and diarrhea following treatment. Endoscopy revealed small bowel Kaposi sarcoma. The patient was treated with systemic chemotherapy successfully without relapse. Conclusions This is the fifth case of Kaposi sarcoma developed over the small intestine in a patient with Crohn’s disease following administration of immunomodulators. Additionally, this case indicated that even short-term immunomodulator use can induce Kaposi sarcoma in patients with inflammatory bowel disease. Thus, in patients with inflammatory bowel disease, if symptoms are aggravated or do not abate after immunomodulators prescription, and before intending to upgrade immunomodulators, endoscopy should be considered. Finally, chemotherapy can also be considered if both medication withdrawal and surgical intervention are not feasible. |
| first_indexed | 2024-04-13T20:39:06Z |
| format | Article |
| id | doaj.art-936b7ffa575e43749620c58b04851c0c |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-13T20:39:06Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-936b7ffa575e43749620c58b04851c0c2022-12-22T02:30:57ZengBMCJournal of Medical Case Reports1752-19472022-11-011611610.1186/s13256-022-03637-8Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literaturePei-Jui Wu0Chi-Shu Sun1Hsing-Tao Kuo2Ming-Jen Sheu3Cheng-Yi Lin4Su-Hung Wang5Chun-Chi Yang6Chi‐Hsing Chen7Shih-Sung Chuang8I-Che Feng9Division of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical CenterDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical CenterDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical CenterDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical CenterDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical CenterDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical CenterDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical CenterDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical CenterDepartment of Pathology, Chi Mei Medical CenterDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical CenterAbstract Background Kaposi sarcoma is a vascular tumor highly related to human herpesvirus-8 and Kaposi sarcoma–associated herpesvirus. Kaposi sarcoma usually manifests as skin or mucosal lesions; involvement in visceral organs such as the gastrointestinal tract is rare. Kaposi sarcoma can occur in immunocompromised patients receiving immunosuppressive therapy, in which case it is known as iatrogenic Kaposi sarcoma or drug-induced Kaposi sarcoma. Intestinal Kaposi sarcoma in patients with inflammatory bowel disease is extremely rare. Case presentation A 46-year-old East Asian male with recently diagnosed Crohn’s disease was administered azathioprine and prednisolone; however, the patient complained of persistent abdominal pain and diarrhea following treatment. Endoscopy revealed small bowel Kaposi sarcoma. The patient was treated with systemic chemotherapy successfully without relapse. Conclusions This is the fifth case of Kaposi sarcoma developed over the small intestine in a patient with Crohn’s disease following administration of immunomodulators. Additionally, this case indicated that even short-term immunomodulator use can induce Kaposi sarcoma in patients with inflammatory bowel disease. Thus, in patients with inflammatory bowel disease, if symptoms are aggravated or do not abate after immunomodulators prescription, and before intending to upgrade immunomodulators, endoscopy should be considered. Finally, chemotherapy can also be considered if both medication withdrawal and surgical intervention are not feasible.https://doi.org/10.1186/s13256-022-03637-8Crohn’s diseaseChemotherapyGastrointestinal Kaposi sarcomaImmunomodulatorKaposi sarcoma |
| spellingShingle | Pei-Jui Wu Chi-Shu Sun Hsing-Tao Kuo Ming-Jen Sheu Cheng-Yi Lin Su-Hung Wang Chun-Chi Yang Chi‐Hsing Chen Shih-Sung Chuang I-Che Feng Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature Journal of Medical Case Reports Crohn’s disease Chemotherapy Gastrointestinal Kaposi sarcoma Immunomodulator Kaposi sarcoma |
| title | Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature |
| title_full | Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature |
| title_fullStr | Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature |
| title_full_unstemmed | Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature |
| title_short | Iatrogenic Kaposi sarcoma of the small bowel in Crohn’s disease following short-term use of immunomodulators: a case report and review of the literature |
| title_sort | iatrogenic kaposi sarcoma of the small bowel in crohn s disease following short term use of immunomodulators a case report and review of the literature |
| topic | Crohn’s disease Chemotherapy Gastrointestinal Kaposi sarcoma Immunomodulator Kaposi sarcoma |
| url | https://doi.org/10.1186/s13256-022-03637-8 |
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