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Enteropathy Associated with the Acquired Immunodeficiency Syndrome

DONALD P. KOTLER, M.D.; HAROLD P. GAETZ, M.D.; MICHAEL LANGE, M.D.; ELENA B. KLEIN, M.D.; and PETER R. HOLT, M.D.
[+] Article and Author Information

Grant support: in part by grant AM 28342 from the National Institutes of Health.

▸Requests for reprints should be addressed to Donald P. Kotler, M.D.; Gastrointestinal Division, S&R 12, St. Luke's-Roosevelt Hospital Center, 114th Street and Amsterdam Avenue; New York, NY 10025.


New York, New York


© 1984 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1984;101(4):421-428. doi:10.7326/0003-4819-101-4-421
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To explore the effect of the acquired immunodeficiency syndrome on gastrointestinal structure and absorption, the cases of 12 homosexual men with the syndrome and 11 homosexual controls were studied. Seven patients had diarrhea with weight loss. Bacterial or parasitic infections were not detected. All patients were malnourished; had significantly fewer T-lymphocyte helper and suppressor cells; and had significantly lower body weights, midarm circumferences, serum albumin concentrations, and iron binding capacities than homosexual controls. D-Xylose malabsorption and steatorrhea were present in patients, especially those with diarrhea. Jejunal and rectal biopsy samples were histologically abnormal in all patients with diarrhea. Jejunal abnormalities included partial villous atrophy with crypt hyperplasia and increased numbers of intraepithelial lymphocytes. Rectal abnormalities included intranuclear viral inclusions, mast cell infiltration in the lamina propria, and focal cell degeneration near the crypt base. The histologic findings suggest that a specific pathologic process occurs in the lamina propria of the small intestine and colon in some patients with the syndrome.

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