Document Detail


Esophageal motility disorders in HIV patients.
MedLine Citation:
PMID:  12772797     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Opportunistic esophageal infections (Candida, cytomegalovirus, herpes simplex virus) and idiophatic esophageal ulcerations are commonly found in HIV patients. However, motility disorders of the esophagus have seldom been investigated in this population. The aim of this prospective study was to determine the presence of motility disorders in HIV patients with esophageal symptoms (with or without associated lesions detected by endoscopy) and in HIV patients without esophageal symptoms and normal esophagoscopy. Eigthteen consecutive HIV patients (10 male, 8 female, ages 20-44 years, mean age 33.5; 8 HIV positive and 10 AIDS) were studied prospectively. Nine patients complained of esophageal symptoms, e.g, dysphagia/odynophagia (group 1) and 9 had symptoms not related to esophageal disease, such as diarrhea, abdominal pain, or gastrointestinal bleeding (group 2). All patients underwent upper endoscopy; mucosal biopsies were taken when macroscopic esophageal lesions were identified or when the patients were symptomatic even if the esophageal mucosa was normal. Esophageal manometry was performed in the 18 patients, using a 4-channel water-perfused system according to a standardized technique. Sixteen of the 18 patients (88.8%) had baseline manometric abnormalities. In group 1, 8/9 patients had esophageal motility disorders: nutcrackeresophagus in 1, hypertensive lower esophageal sphincter (LES) with incomplete relaxation in 2, nonspecific esophageal motility disorders (NEMD) in 3, diffuse esophageal spasm in 1, esophageal hypocontraction with low LES pressure in 1. Six of these 9 patients had lesions detected by endoscopy: CMV ulcers in 2, idiopathic ulcers in 1, candidiasis in 1, idiopathic ulcer + candidiasis in 1, nonspecific esophagitis in 1; and 3/9 had normal endoscopy and normal esophageal biopsies. In group 2, 8/9 patients had abnormal motility: hypertensive LES with incomplete relaxation in 1, nutcracker esophagus in 2, esophageal hypocontraction in 3, and NEMD in 2. All these patients had a normal esophageal mucosa at endoscopy. In conclusion, our findings suggest that HIV patients have esophageal motility disorders independent of esophageal symptoms and/or the presence of mucosal esophageal lesions.
Authors:
Alberto E Zalar; Martín A Olmos; Eduardo L Piskorz; Fernando L Magnanini
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  48     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-29     Completed Date:  2003-06-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  962-7     Citation Subset:  AIM; IM    
Affiliation:
División de Gastroenterologia, Hospital Juan A. Fernández, Buenos Aires, Argentina.
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / diagnosis,  epidemiology
Adult
Comorbidity
Esophageal Motility Disorders / diagnosis,  epidemiology*
Esophagoscopy
Female
Follow-Up Studies
HIV Infections / diagnosis,  epidemiology*
Humans
Incidence
Male
Manometry / methods
Prospective Studies
Risk Factors
Sampling Studies
Severity of Illness Index
Sex Distribution

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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