CROHNS ILEITIS IN A PATIENT WITH LONGSTANDING HIV-INFECTION

The differential diagnosis of diarrhea in patients infected with HIV i s broad, and includes a variety of bacterial, viral, and parasitic pat hogens, as well as malignancies including lymphoma and Kaposi's sarcom a. Idiopathic non-specific inflammatory bowel disease rarely occurs in association with HIV infection. A recent case report described a pati ent with longstanding Crohn's disease who experienced remission of his bowel disease upon infection with HIV (6). The authors inferred that the remission was secondary to a depressed CD4 (T helper) lymphocyte c ount. We report the first case of Crohn's ileitis developing in a pati ent with established HIV infection, depressed CD4 lymphocyte count, an d no prior history of inflammatory bowel disease. This case raises que stions about the role of CD4 cells in the pathogenesis of Crohn's dise ase.