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Gastrointestinal manifestations of AIDS in children

J O Haller1, H L Cohen

  • 1Department of Radiology, State University of New York Health Science Center, Downstate Medical Center, Brooklyn 11203.

AJR. American Journal of Roentgenology
|February 1, 1994
PubMed

Insights

Gastrointestinal issues in children with acquired immunodeficiency syndrome (AIDS) stem from opportunistic infections and cancers. These conditions are more severe and persistent in pediatric AIDS patients, requiring specialized treatment approaches.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Oncology

Background:

  • Gastrointestinal (GI) manifestations in children with acquired immunodeficiency syndrome (AIDS) are frequently linked to opportunistic infections, lymphoproliferative disorders, and malignancies.
  • While these GI infections occur in non-AIDS patients, they present with increased severity, relapse rates, and eradication challenges in pediatric AIDS cases.

Purpose of the Study:

  • To delineate the spectrum of gastrointestinal manifestations in children diagnosed with AIDS.
  • To identify common opportunistic infections, neoplasms, and their associated radiologic findings in this vulnerable population.

Main Methods:

  • Review of clinical presentations, diagnostic findings, and treatment outcomes for pediatric AIDS patients with GI symptoms.
  • Analysis of radiologic studies (e.g., barium studies) and microbiological data to identify causative agents and disease patterns.

Main Results:

  • Candidiasis, herpes simplex virus, and cytomegalovirus (CMV) are common esophageal infections. CMV is a frequent cause of gastritis and enteritis, leading to ulcerations via vasculitis.
  • Radiologic findings include ulcerations, cobblestone appearance, disordered motility, mucosal nodularity, and effacement. Other pathogens identified include Mycobacterium avium-intracellulare, Mycobacterium tuberculosis, Campylobacter, Giardia, and Cryptosporidium.
  • CMV is particularly virulent in colitis and proctitis, potentially causing necrosis, perforation, and mortality. Common neoplasms include lymphoma, smooth muscle tumors, and Kaposi's sarcoma.

Conclusions:

  • Gastrointestinal complications in pediatric AIDS are diverse, primarily driven by opportunistic infections and malignancies.
  • Prompt diagnosis and management of these GI issues are critical due to their potential severity and impact on patient outcomes.

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