Severe gastrointestinal hemorrhage due to mycobacterium avium complex in apatient receiving immunosuppressive therapy

Citation
Hn. Nguyen et al., Severe gastrointestinal hemorrhage due to mycobacterium avium complex in apatient receiving immunosuppressive therapy, AM J GASTRO, 94(1), 1999, pp. 232-235
Citations number
26
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
AMERICAN JOURNAL OF GASTROENTEROLOGY
ISSN journal
00029270 → ACNP
Volume
94
Issue
1
Year of publication
1999
Pages
232 - 235
Database
ISI
SICI code
0002-9270(199901)94:1<232:SGHDTM>2.0.ZU;2-3
Abstract
Intense immunosuppressive therapy is used frequently for treatment of syste mic vasculitides, collagenoses, rapidly progressive glomerulonephritis, and after organ transplantation. Numerous serious treatment-related side effec ts include localized or disseminated opportunistic infections, and require careful monitoring of immunosuppressed patients. Gastrointestinal infection s with Mycobacterium avium complex (MAC) or other nontuberculous mycobacter ia have been previously identified in HIV seropositive patients only. We no w report the first case of an HIV seronegative patient who received immunos uppressive therapy for rapidly progressive glomerulonephritis. The patient presented with severe lower gastrointestinal bleeding and was diagnosed to have ulcerative colitis due to infection with MAC. The patient recovered pr omptly after administration of antimycobacterial therapy. MAC infection sho uld be included in the differential diagnosis of gastrointestinal bleeding in all immunodeficient patients. The significance of repeated colonoscopy t o obtain multiple biopsy specimens with histological examination for foam c ells and specific staining for acid-fast organisms is emphasized. (C) 1999 by Am. Coll. of Gastroenterology.