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Pancreatic abnormalities and AIDS related sclerosing cholangitis
J P Teare1, C A Daly, C Rodgers
1Department of Gastroenterology, St Mary's Hospital, Paddington, London.
Genitourinary Medicine
|August 1, 1997
Summary
Opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS) frequently cause biliary tract disease. Pancreatic abnormalities, including ductal dilatation, are common in AIDS-related sclerosing cholangitis (ARSC).
Area of Science:
- Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Biliary tract abnormalities are common in patients with acquired immunodeficiency syndrome (AIDS), often due to opportunistic infections like Cryptosporidium, Microsporidium, and cytomegalovirus.
- A high frequency of pancreatic abnormalities was observed in conjunction with biliary tract disease in these patients.
Purpose of the Study:
- To define the clinical and radiological features of pancreatic abnormalities in patients with AIDS and biliary tract disease.
- To investigate the relationship between biliary tract disease and pancreatic abnormalities in HIV-positive individuals.
Main Methods:
- Review of clinical notes and radiographs from 83 HIV-positive patients who underwent endoscopic retrograde cholangiopancreatography (ERCP).
- Investigation focused on patients with cholestatic liver function tests or abdominal pain.
Main Results:
- 56 patients had AIDS-related sclerosing cholangitis (ARSC), presenting with epigastric/right upper quadrant pain and hepatomegaly.
- The most frequent biliary abnormality was papillary stenosis combined with ductal sclerosis.
- Pancreatograms in patients with papillary stenosis revealed an 81% incidence of pancreatic duct dilatation, often with features of chronic pancreatitis.
Conclusions:
- Pancreatic abnormalities are frequently associated with ARSC and may contribute to persistent pain.
- Papillary stenosis and ductal sclerosis are the most common radiographic findings in the biliary tract of these patients.
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