MDCT AND MRI FEATURES OF PANCREATIC NECROSIS IN PATIENTS WITH END STAGE OF HIV

The purpose of this retrospective study was to explore peculiarities of pancreatic necrosis in patients with end-stage HIV infection using MDCT and MRI. Comparisons with subsequent pathological studies revealed features of the pancreatonecrosis course: protracted persistent course, with a tendency to relapse, delimitation of exudative processes, depending on the predominance of one or another AIDS-related infections. Pancreatonecrosis on a background of generalized toxoplasmosis was observed in 2 patients (18%) and was accompanied by formation of specific cysts secondary to the presence of hemorrhage and calcination, mesenteric lymphadenopathy, without the presence of additional inflammatory fluid streaks. Pancreatonecrosis on a background of generalized tuberculosis was observed in 4 patients (36%). It noted the severe and widespread destruction of pancreas with miliary parenchymal and mesenteric dissimination, mesenteric lymphadenopathy, the presence of additional inflammatory fluid streaks in the abdominal cavity and retroperitoneal space. The density of inflammatory fluid streaks was relatively high, at 15-30 HU. Out of 5 (46%) evaluable patients with pancreatic necrosis on the background of generalized mycosis 2 had revealed candidiasis, in 1 - cryptococcosis, in 2 - actinomycosis. Destruction of the pancreas on the background of different fungal infection accompanied by the appearance of multiple focal formations (microabscesses) due to rapidly emerging adhesions in exudative changes mild abdominal and mesenteric lymphadenopathy and had no significant differences depending on the pathogen.

вирус иммунодефицита человека (ВИЧ), синдром приобретенного иммунодефицита (СПИД), панкреонекроз, генерализованный токсоплазмоз, микоз, туберкулез, желудочно-кишечный тракт, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), pancreatonecrosis, generalized toxoplasmosis, mycosis, tuberculosis, gastrointestinal tract

1. Лысенко А. Я. ВИЧ-инфекция и СПИД-ассоциированные заболевания / А. Я. Лысенко, М. X. Турьянов, М. В. Лавдовская, В. М. Подольский.- М.: ТОО «Рарогь», 1996.

2. Покровский В. В. ВИЧ-инфекция / В. В. Покровский, Н. Н. Ладная, Е. В. Буравцова // Биология и медицина.- 2000.- № 18.- С. 8-14.

3. Покровский В. И. Синдром приобретенного иммунодефицита / В. И. Покровский, В. В. Покровский.- М., 1988.

4. Савельева Т. В. Лучевая диагностика изменений органов брюшной полости и забрюшинного пространства у ВИЧ-инфицированных пациентов / Т. В. Савельева, Т. Н. Трофимова, В. В. Рассохин // ВИЧ-инфекция и иммуносупрессии.- 2010.- № 3.- С. 15-22.

5. Huang L. HIV-associated opportunistic pneumonias / L. Huang, K. Crothers / Division of Pulmonary, Department of Medicine, San Francisco General Hospital, University of California.- San Francisco, 2009.

6. Lawn S. D. Antiretroviral therapy for control of the HIVassociated tuberculosis epidemic in resource limited settings / S. D. Lawn, K. Kranzer, R. Wood // Clinics in Chest Medicine.- 2009.- Vol. 30 (4).- Р. 685-699.

7. Liver biopsy findings in 501 patients infected with human immunodeficiency virus (HIV) // J. Acquir. Immune Defic Syndr Hum Retrovirol.- 1996.- Vol. 11.- Р. 170-177.

8. Neuman M. G. HIV-Antiretroviral Therapy Induced Liver, Gastrointestinal, and Pancreatic Injury / M. G. Neuman, M. Schneider, R. M. Nanau, C. Parry // Int. J. Hepatol.- 2012; 2012: 760706. doi:10.1155/2012/760706.

9. Wahl S. M. Co-infection with opportunistic pathogens promotes human immunodeficiency virus type 1 infection in macrophages / S. M. Wahl, T. Greenwell-Wild, G. Peng // J. Infect. Dis.- 1999.- Vol. 179.- P. 457-460.