AIDS cholangiopathy

AIDS cholangiopathy refers to an acalculous, secondary opportunistic cholangitis that occurs in AIDS patients as a result of immunosuppression.

Pathology

Characterized by multiple irregular strictures essentially indistinguishable from primary sclerosing cholangitis (PSC). There are four pathological patterns:

• a combination of sclerosing cholangitis and papillary stenosis (50%)
• isolated intrahepatic sclerosing cholangitis–like appearance (20%)
• isolated papillary stenosis (15%)
• long-segment extrahepatic duct stricture +/- concurrent intrahepatic disease (15%)

Etiology

No definite organism is identified in up to half of the patients. It typically affects patients with low CD4 counts (<135/mm). Postulated causative organisms include:

• cytomegalovirus (CMV)
• herpes simplex virus (HSV)
• Cryptosporidium parvum
• Microsporidium
• Mycobacterium avium complex

Differential diagnosis

• chemotherapy-induced cholangitis
• primary sclerosing cholangitis (PSC)
• eosinophilic cholangitis

Siehe auch:

• Cholangitis
• Primär sklerosierende Cholangitis
• AIDS
• durch Chemotherapie induzierte Cholangitits