Departments of Gastroenterology, Infectious Diseases, and Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
ABSTRACT
Acquired immunodeficiency syndrome (AIDS) cholangiopathy is a form of biliary tract inflammation with or without stricture seen in severely immunocompromised AIDS patients. It is rare in countries where highly active antiretroviral therapy is employed. In this case, a 40-year-old man with chronic diarrhea for 6 months was diagnosed as colitis caused by cytomegalovirus (CMV) and Entamoeba histolytica coinfection. At the time of the human immunodeficiency virus (HIV) infection diagnosis, he had immunodeficient status with low CD4 count [55/μL]. Serial follow up of liver enzymes were elevated and a CT scan of the abdomen disclosed dilatation of extrahepatic and intrahepatic bile duct and prominent ampulla. Strictures and beading of the right intrahepatic ducts were seen on endoscopic retrograde cholangiopancreatography (ERCP), and biopsy was done at ampulla. Histological examination revealed CMV infection. We report this rare case of AIDS cholangiopathy with CMV papillitis. He was treated with ganciclovir and UDCA after EST.
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