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1996-02-26
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Document 1069
DOCN M9621069
TI Diagnosis and prognosis of AIDS-related cholangitis.
DT 9602
AU Ducreux M; Buffet C; Lamy P; Beaugerie L; Fritsch J; Choury A; Liguory
C; Longuet P; Gendre JP; Vachon F; et al; Department of
Hepato-Gastroenterology, Bicetre Hospital, Le; Kremlin Bicetre, France.
SO AIDS. 1995 Aug;9(8):875-80. Unique Identifier : AIDSLINE MED/96014960
AB OBJECTIVE: To determine more precisely the clinical and biological
characteristics of AIDS-related cholangitis, and to investigate
prognostic variables of this disease. DESIGN: Retrospective clinical and
prognostic study. SETTING: Biliary unit, Bicetre Hospital, France.
PATIENTS: HIV-positive patients (n = 52) referred to the unit between
December 1986 and June 1993 for biliary symptoms leading to the
suspicion of AIDS-related cholangitis, (42 men; 10 women; mean age, 37
+/- 8 years). INTERVENTION: Endoscopic retrograde
cholangiopancreatography (ERCP) was performed in order to determine the
cause of the biliary symptoms. MAIN OUTCOME MEASURE: Clinical features
and evolution of the cholangitis. RESULTS: Among the 52 patients, 45 met
the ERCP criteria of AIDS-related cholangitis (36 men; nine women). The
diagnosis of cholangitis was strongly suggested by abdominal
ultrasonography in 47% of the cases. ERCP showed papillary stenosis,
diffuse cholangitis, extrahepatic cholangitis alone, and intrahepatic
cholangitis alone in 60, 67, 7 and 27%, respectively. Endoscopic
sphincterotomy was performed in 28 patients. Pain was relieved by
sphincterotomy in nine patients, but the other clinical or biological
features were not influenced. One-year and 2-year survival rates were 41
+/- 7% and 8 +/- 4%, respectively. Multidimensional analysis using a Cox
model showed that a lymphocyte count > 500 x 10(6)/l was the only
independent predictive factor of better survival. CONCLUSION:
AIDS-related cholangitis is a disease which leads preferentially to
papillary stenosis or diffuse abnormalities of the biliary tract.
Prognostic factors depend on the stage of the HIV infection. Another
diagnosis of cholestasis was found in approximately 15% of the patients
who showed biliary symptoms.
DE Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Alanine
Aminotransferase/BLOOD Alkaline Phosphatase/BLOOD Bilirubin/BLOOD
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis/*COMPLICATIONS/*DIAGNOSIS/SURGERY Female Human Lymphocyte
Count Male Middle Age Prognosis Retrospective Studies
Sphincterotomy, Endoscopic JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).