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    Use of thalidomide in treatment and maintenance of idiopathic esophageal ulcers in HIV+ individuals
    Digestive Diseases and Sciences (1995)
    Scott M. NaumPeter J. MolloyRobert J. KaniaJanet McGarrDavid H. Van Thiel
    22
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    Thalidomide effective for oral ulcers.
    PubMed (1996)
    A National Institutes of Health (NIH) study found that thalidomide heals oral aphthous ulcers in HIV-positive people. Severe mouth ulcers were healed in 14 of 23 patients receiving thalidomide compared to 1 of 22 patients receiving placebo. Patients received 200 mg thalidomide per day for 4 weeks. During the second maintenance phase of the study, all patients will receive open-label thalidomide in an attempt to determine the drug's ability to prevent the recurrence of ulcers in the mouth or esophagus. Patients suffering from esophageal ulcers will continue to be randomized to thalidomide or placebo because, due to the limited trial enrollment, the drug's effectiveness was undeterminable.
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    Proceedings of the international meeting on normal and neoplastic growth in hepatology, Bari, Italy, June 1989.
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    Mucosal metabolic activity in endoscopic intestinal biopsy specimens
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    P. GiamundoM. GrahnP. R. O’ConnellN S Williams
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    Transplant Hepatology Fellowship Websites: The Good, the Bad, and the Unhelpful
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    Prospective evaluation of oropharyngeal findings in human immunodeficiency virus-infected patients with esophageal ulceration.
    PubMed (1995)
    C. Mel WilcoxRobert F. StraubW. Scott Clark
    Although the presence of oropharyngeal (OP) candidiasis plays an important role in the evaluation of human immunodeficiency virus (HIV)-infected patients with esophageal symptoms, there is little information on the utility of OP findings in patients with esophageal ulceration.Over a 54-month period, all HIV-infected patients with esophageal ulceration had careful inspection of the oropharynx at the time of presentation with esophageal complaints and at endoscopy. HIV-infected patients without esophageal ulceration undergoing endoscopy during the last 30 months had OP findings similarly documented. OP ulceration ulceration was determined based on clinical, endoscopic, and histopathological findings.Of the 124 patients identified with esophageal ulcer, 14 (11%) had coexistent OP ulceration: herpes simplex virus, four; idiopathic esophageal ulcer, four; cytomegalovirus, three; herpes simplex virus and cytomegalovirus, two; idiopathic and cytomegalovirus, one. Four patients had OP ulcer without esophageal ulcer; only one of these patients had esophageal symptoms. All OP lesions healed with therapy for the esophageal ulcer. Twenty-eight patients with esophageal ulcer had OP candidiasis (23%); 21 of these patients (75%) also had Candida esophagitis. The sensitivity and specificity of OP ulcer for esophageal ulcer were 11% and 97%, respectively. The positive and negative predictive values of OP candidiasis for esophageal candidiasis were 90% and 82%, respectively.OP ulceration is uncommon in patients with esophageal ulceration, with the exception of herpes simplex virus esophagitis. OP candidiasis is common in patients with underlying esophageal ulcer, potentially resulting in diagnostic confusion. OP candidiasis appears to be a moderately useful diagnostic marker for Candida esophagitis.
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