Prospective comparison of brush cytology, viral culture, and histology for the diagnosis of ulcerative esophagitis in AIDS

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
C M WilcoxAudrey Lazenby

Abstract

The best method(s) for the diagnosis of esophageal ulcers in patients with acquired immune deficiency syndrome (AIDS) is unknown. Over an 8-year period, all human immunodeficiency virus (HIV)-infected patients with a CD4 lymphocyte count of < or =250/mm(3) and an esophageal ulcer underwent a standard protocol consisting of 2 biopsy examinations for viral culture (shell vial technique), brushing for cytology with immunohistochemistry (IHC) for viral antigens, and 10 biopsy examinations of the ulcer base/edge for routine histology and IHC. The cause of ulcer was based on histologic findings and clinical and endoscopic follow-up evaluation after therapy. Forty patients with 48 episodes of ulcer were studied (mean age, 34 yr; 88% men; median CD4 lymphocyte count = 31 cells/mm(3); range, 0-250 cells/mm(3)). Six patients had more than one endoscopic examination documenting ulcer, and 2 patients had more than one cause of ulcer. The most common causes of ulcer were: idiopathic (IEU) 22, cytomegalovirus (CMV) 15, and gastroesophageal reflux disease 6. Viral culture was positive for herpes simplex in 3 of 3, but only 4 of 15 (27%) for CMV, and specificity of viral culture was 100%. Cytologic brushings were only positive in the patients ...Continue Reading

References

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Citations

Dec 4, 2008·Digestive Diseases and Sciences·Marcos Carvalho BorgesBenedito Antônio Lopes Fonseca
Jul 28, 2015·Expert Review of Hematology·Miguela A CanizaMiguel Bonilla
Feb 6, 2016·Current Treatment Options in Gastroenterology·Nitin K Ahuja, John O Clarke
Jul 23, 2013·Gastrointestinal Endoscopy·Ravi N SharafBrooks D Cash
Nov 23, 2013·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Byung Hoo LeeSo Young Jin
Oct 9, 2018·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·P HoverstenD A Katzka
Jun 18, 2020·ACG Case Reports Journal·Zarir AhmedChristine Hachem
Jun 24, 2016·Microbiology Spectrum·Kevin Alby, Irving Nachamkin

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