Localised intestinal Kaposi sarcoma in a patient with non-coeliac seronegative villous atrophy

BMJ Case Rep. 2023 Sep 26;16(9):e254073. doi: 10.1136/bcr-2022-254073.

Abstract

Seronegative villous atrophy (SNVA) is a diagnostic challenge for gastroenterologists, which is defined by villous atrophy and negative coeliac serology. Non-coeliac forms of SNVA, such as autoimmune enteropathy, can be life-threatening leading to intractable diarrhoea and severe malabsorption that require systemic immunosuppression. When all known causes have been excluded, it is termed idiopathic villous atrophy (IVA). We present a case of non-coeliac SNVA complicated by Kaposi sarcoma (KS). A previously well HIV-negative man in his 30s presented with a 4-month history of watery diarrhoea and 25 kg weight loss. After prolonged investigation, he was diagnosed with non-coeliac SNVA without an identified aetiology that would be consistent with IVA. Clinical recovery was achieved with parenteral nutrition for type II intestinal failure and immunosuppression using high-dose corticosteroids. On subsequent gastroscopy, he was diagnosed with localised intestinal KS prompting cessation of all immunosuppression but remained in clinical remission.

Keywords: Malabsorption; Malnutrition; Small intestine.

Publication types

  • Case Reports

MeSH terms

  • Atrophy / pathology
  • Celiac Disease* / diagnosis
  • Diarrhea
  • Humans
  • Intestines
  • Male
  • Sarcoma, Kaposi* / complications
  • Sarcoma, Kaposi* / diagnosis
  • Sarcoma, Kaposi* / pathology