Hamour AA, Khoo S, Bonnington A, Barnes A, Fraser I, Bailey G, Wilkins EG, Denning DW, Dunbar EM, Mandal BK; International Conference on AIDS.
Int Conf AIDS. 1992 Jul 19-24; 8: 87 (abstract no. PuB 7229).
Regional Department of Infectious Diseases & Tropical Medicine, Monsall Hospital, Manchester, U.K.
INTRODUCTION: Sclerosing cholangitis associated with cryptosporidium is a well recognised complication of the acquired immunodeficiency syndrome (AIDS). Successful treatment of this condition has not been previously reported. CASE REPORT: A 34 years old homosexual man with AIDS presented in October 1991 with obstructive jaundice and intermittent diarrhoea. The bilirubin was 133 micromol/L and the alkaline phosphatase 830 IU/L. Abdominal ultrasound and computerised tomography showed an enlarged liver with dilated intrahepatic ducts. Endoscopic retrograde cholangiopancreatography (ERCP) revealed multiple strictures of the biliary tree with bending consistent with sclerosing cholangitis. Cryptosporidial oocysts were detected in the bile but there were no other pathogens including CMV. He has treated with intravenous Paromomycin (500 mg t.d.s. for 16 days) which was followed by rapid clinical improvement and his liver function tests gradually returned to normal (bilirubin 10 micromol/L. alkaline phosphatase 358 IU/L). Paromomycin was followed by oral Letrazuril as maintenance therapy. Four months after his initial presentation he remains well and asymptomatic with normal hepatic function. CONCLUSION: Paromomycin and Letrazuril should be considered for the treatment of AIDS-related cryptosporidial sclerosing cholangitis. Further studies of the efficacy and toxicity of this combination are needed.
Publication Types:
Keywords:
- Acetonitriles
- Acquired Immunodeficiency Syndrome
- Animals
- Bile Ducts, Intrahepatic
- Cholangiopancreatography, Endoscopic Retrograde
- Cholangitis
- Cholangitis, Sclerosing
- Constriction, Pathologic
- Cryptosporidium
- Disease Progression
- Humans
- Male
- Paromomycin
- Tomography, X-Ray Computed
- Triazines
- letrazuril
- methods
- radiography
Other ID:
UI: 102202230
From Meeting Abstracts