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Acta Endoscopica

, Volume 36, Issue 3, pp 343–355 | Cite as

Colites parasitaires et immunodéficiences

  • Ph. Rey
  • J. M. Debonne
  • Ch. Bredin
  • F. Klotz
Article
  • 68 Downloads

Parasitic colitis and immunodeficiency

Résumé

Les colites parasitaires au cours des immunodéficiences sont surtout observées lors de déficits de l’immunité cellulaire, dominés en fréquence par l’infection par le virus de l’immunodéficience humaine. Les parasitoses en cause sont des protozooses digestives (amibiase, blastocystose, balantidiose, dientamoebiase, cryptopsoridiose, isosporose), plus rarement extra-digestives (leishmaniose viscérale, toxoplasmose, pneumocystose). La strongyloïdose est l’unique helminthiase concernée. Ces colites ont une connotation péjorative pour plusieurs raisons: intensité du déficit immun sous-jacent; colite d’expression clinique grave, compliquée ou prolongée; dissémination de la parasitose et fréquente association à d’autres agents pathogènes ou manifestations tumorales, induits également par l’immunodéficit et qui modifient les tableaux cliniques; difficultés diagnostiques justifiant une coopération entre le clinicien, le biologiste et l’endoscopiste digestif; traitements souvent en échec justifiant le recours à des alternatives inconstamment validées.

Summary

Parasitic colitis in immunodeficient patients is mainly observed in cases of cellular immunodeficiency, and most frequently in cases of infection by human immunodeficiency virus (HIV). The parasitic infections concerned (amoebiasis, blastocystosis, balantidiosis, dientamoebiasis, cryptosporidiosis, isosporosis) are caused by enteric protozoans and, more rarely, nonenteric protozoans (visceral leishmaniasis, toxoplasmosis, and pneumocystosis). Regarding helminthiasis, only strongyloidiasis is present. Many factors are responsible for the pejorative connotation of these types of colitis: the intensity of underlying immunodeficiency; a severe, longstanding or complicated clinical presentation; parasite seeding, frequent association with other pathogenic agents or tumoural patterns induced by the immunodeficiency itself modifying the clinical data; diagnostic difficulties requiring close collaboration between clinician, biologist and endoscopist; and, lastly, frequent therapeutic failures calling for alternative therapies that are not always validated.

Mots-clés

colites endoscopie immunodéficience parasites VIH 

Key-words

colitis endoscopy immunodeficiency parasites HIV 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Ph. Rey
    • 1
  • J. M. Debonne
    • 2
  • Ch. Bredin
    • 1
  • F. Klotz
    • 3
  1. 1.Service des maladies digestivesHôpital d’Instruction des Armées LegouestMetz-ArméesFrance
  2. 2.Service des maladies digestivesHôpital d’Instruction des Armées LaveranMarseille ArméesFrance
  3. 3.Hôpital principalDakarSénégal

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