Skip to main content
Gut logoLink to Gut
. 1995 Feb;36(2):283–286. doi: 10.1136/gut.36.2.283

Natural history and prognosis of diarrhoea of unknown cause in patients with acquired immunodeficiency syndrome (AIDS).

C Blanshard 1, B G Gazzard 1
PMCID: PMC1382418  PMID: 7883231

Abstract

This paper is a prospective study of patients with advanced human immunodeficiency virus infection and chronic diarrhoea for which no cause could be found after extensive investigations, including examination of multiple stool specimens for all known faecal pathogens and the histological examination of small and large bowel biopsy specimens. Of 39 such patients recruited from 155 prospectively investigated patients, eight had a possible cause of diarrhoea identified on follow up investigations, including small bowel neoplasms in three and cytomegalovirus in two. In 17 of the remaining 31 the diarrhoea resolved completely in a mean of seven months from its onset. Eleven had continuing mild or intermittent diarrhoea and three had more than 1 litre of diarrhoea daily for which no cause could be found. The median survival for patients with 'pathogen negative' diarrhoea was 48.7 months, which is similar to that of control patients with no diarrhoea and significantly longer than that of matched patients with a gastrointestinal pathogen (9.6 months).

Full text

PDF
285

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Afzalpurkar R. G., Schiller L. R., Little K. H., Santangelo W. C., Fordtran J. S. The self-limited nature of chronic idiopathic diarrhea. N Engl J Med. 1992 Dec 24;327(26):1849–1852. doi: 10.1056/NEJM199212243272605. [DOI] [PubMed] [Google Scholar]
  2. Antony M. A., Brandt L. J., Klein R. S., Bernstein L. H. Infectious diarrhea in patients with AIDS. Dig Dis Sci. 1988 Sep;33(9):1141–1146. doi: 10.1007/BF01535791. [DOI] [PubMed] [Google Scholar]
  3. Batman P. A., Miller A. R., Sedgwick P. M., Griffin G. E. Autonomic denervation in jejunal mucosa of homosexual men infected with HIV. AIDS. 1991 Oct;5(10):1247–1252. doi: 10.1097/00002030-199110000-00015. [DOI] [PubMed] [Google Scholar]
  4. Belitsos P. C., Greenson J. K., Yardley J. H., Sisler J. R., Bartlett J. G. Association of gastric hypoacidity with opportunistic enteric infections in patients with AIDS. J Infect Dis. 1992 Aug;166(2):277–284. doi: 10.1093/infdis/166.2.277. [DOI] [PubMed] [Google Scholar]
  5. Bessesen M. T., Wang E., Echeverria P., Blaser M. J. Enteroinvasive Escherichia coli: a cause of bacteremia in patients with AIDS. J Clin Microbiol. 1991 Nov;29(11):2675–2677. doi: 10.1128/jcm.29.11.2675-2677.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Budhraja M., Levendoglu H., Kocka F., Mangkornkanok M., Sherer R. Duodenal mucosal T cell subpopulation and bacterial cultures in acquired immune deficiency syndrome. Am J Gastroenterol. 1987 May;82(5):427–431. [PubMed] [Google Scholar]
  7. Colebunders R., Lusakumuni K., Nelson A. M., Gigase P., Lebughe I., van Marck E., Kapita B., Francis H., Salaun J. J., Quinn T. C. Persistent diarrhoea in Zairian AIDS patients: an endoscopic and histological study. Gut. 1988 Dec;29(12):1687–1691. doi: 10.1136/gut.29.12.1687. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Connolly G. M., Forbes A., Gleeson J. A., Gazzard B. G. The value of barium enema and colonoscopy in patients infected with HIV. AIDS. 1990 Jul;4(7):687–689. doi: 10.1097/00002030-199007000-00014. [DOI] [PubMed] [Google Scholar]
  9. Connolly G. M., Shanson D., Hawkins D. A., Webster J. N., Gazzard B. G. Non-cryptosporidial diarrhoea in human immunodeficiency virus (HIV) infected patients. Gut. 1989 Feb;30(2):195–200. doi: 10.1136/gut.30.2.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Cummins A. G., LaBrooy J. T., Stanley D. P., Rowland R., Shearman D. J. Quantitative histological study of enteropathy associated with HIV infection. Gut. 1990 Mar;31(3):317–321. doi: 10.1136/gut.31.3.317. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Friedman S. L., Wright T. L., Altman D. F. Gastrointestinal Kaposi's sarcoma in patients with acquired immunodeficiency syndrome. Endoscopic and autopsy findings. Gastroenterology. 1985 Jul;89(1):102–108. doi: 10.1016/0016-5085(85)90750-4. [DOI] [PubMed] [Google Scholar]
  12. Kelly P., Buve A. Chemotherapy of African AIDS diarrhoea: a preliminary study. AIDS. 1993 Jan;7(1):91–93. doi: 10.1097/00002030-199301000-00014. [DOI] [PubMed] [Google Scholar]
  13. Kotler D. P., Gaetz H. P., Lange M., Klein E. B., Holt P. R. Enteropathy associated with the acquired immunodeficiency syndrome. Ann Intern Med. 1984 Oct;101(4):421–428. doi: 10.7326/0003-4819-101-4-421. [DOI] [PubMed] [Google Scholar]
  14. Kotler D. P., Orenstein J. M. Chronic diarrhea and malabsorption associated with enteropathogenic bacterial infection in a patient with AIDS. Ann Intern Med. 1993 Jul 15;119(2):127–128. doi: 10.7326/0003-4819-119-2-199307150-00006. [DOI] [PubMed] [Google Scholar]
  15. Maddox A., Francis N., Moss J., Blanshard C., Gazzard B. Adenovirus infection of the large bowel in HIV positive patients. J Clin Pathol. 1992 Aug;45(8):684–688. doi: 10.1136/jcp.45.8.684. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Rolston K. V., Rodriguez S., Hernandez M., Bodey G. P. Diarrhea in patients infected with the human immunodeficiency virus. Am J Med. 1989 Jan;86(1):137–138. doi: 10.1016/0002-9343(89)90251-9. [DOI] [PubMed] [Google Scholar]
  17. Steinberg J. J., Bridges N., Feiner H. D., Valensi Q. Small intestinal lymphoma in three patients with acquired immune deficiency syndrome. Am J Gastroenterol. 1985 Jan;80(1):21–26. [PubMed] [Google Scholar]
  18. Weber R., Bryan R. T., Owen R. L., Wilcox C. M., Gorelkin L., Visvesvara G. S. Improved light-microscopical detection of microsporidia spores in stool and duodenal aspirates. The Enteric Opportunistic Infections Working Group. N Engl J Med. 1992 Jan 16;326(3):161–166. doi: 10.1056/NEJM199201163260304. [DOI] [PubMed] [Google Scholar]
  19. van Gool T., Snijders F., Reiss P., Eeftinck Schattenkerk J. K., van den Bergh Weerman M. A., Bartelsman J. F., Bruins J. J., Canning E. U., Dankert J. Diagnosis of intestinal and disseminated microsporidial infections in patients with HIV by a new rapid fluorescence technique. J Clin Pathol. 1993 Aug;46(8):694–699. doi: 10.1136/jcp.46.8.694. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES