Adele Barbaccia
Kaposi’s sarcoma in myasthenia gravis patient in oral steroids treatment: two case report
Autori
- ADELE BARBACCIA (DEPARTMENT OF CLINICAL AND EXPERIMENTAL MEDICINE, UNIVERSITY OF MESSINA, MESSINA, ITALY – NEUROLOGY)
- ALESSIA PUGLIESE (DEPARTMENT OF CLINICAL AND EXPERIMENTAL MEDICINE, UNIVERSITY OF MESSINA, MESSINA, ITALY – NEUROLOGY)
- FIAMMETTA BIASINI (DEPARTMENT OF CLINICAL AND EXPERIMENTAL MEDICINE, UNIVERSITY OF MESSINA, MESSINA, ITALY – NEUROLOGY)
- ALBA MIGLIORATO (DEPARTMENT OF BIOMEDICAL AND DENTAL SCIENCES AND MORPHO-FUNCTIONAL IMAGING, UNIVERSITY OF MESSINA, ITALY – BIOLOGY)
- CARMELO RODOLICO (DEPARTMENT OF CLINICAL AND EXPERIMENTAL MEDICINE, UNIVERSITY OF MESSINA, MESSINA, ITALY – NEUROLOGY)
Presentatore
ADELE BARBACCIA (DEPARTMENT OF CLINICAL AND EXPERIMENTAL MEDICINE, UNIVERSITY OF MESSINA, MESSINA, ITALY)
Modalità
Poster Session
Abstract
“Background: Myasthenia gravis (MG) is an autoimmune neuromuscular disease, whose treatment includes acetylcholinesterase inhibitors, oral steroids, and other immunosuppressants. Kaposi’s sarcoma (KS) is a lymphangioproliferative disease associated with human herpesvirus 8 (HHV-8) infection, immunodeficiency and/or immunosuppression, rarely related to steroid therapy.
Case reports: We describe two cases of generalized-MG patients treated with oral steroids who developed KS. The first patient was a 70 years old woman affected by generalized MG with oculobulbar involvement. The second one was idem. They developed disseminated and lower limbs cutaneous KS lesions, respectively, under treatment with prednisone and azathioprine for myasthenia gravis. Doxorubicin therapy was started in the first case, resulting in a partial KS remission. No chemotherapy was introduced in the other case, but just a progressive tapering of steroid therapy led to KS lesions’ improvement.
Conclusions: Steroid therapy associated KS is an uncommon, but not impossible event. Indeed, skin evaluation should be performed in all patients with chronic steroid therapy. Steroid tapering is usually sufficient to control the disease, but sometimes chemotherapy is needed. Furthermore, steroid-sparing agents may be considered to reduce KS and other steroid-related comorbidities. Finally, HHV-8 positivity should be tested before starting chronic immunosuppression.”