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Peer-reviewedCC BY 4.0Case Reports in Gastrointestinal Medicine

Gastrointestinal Kaposi Sarcoma as the Initial Presentation of Undiagnosed HIV Infection: A Case of Unexplained Anemia

  • Amir Omar1
  • Tracy Zouein2
  • Rayane Salameh3
  • Karim Zodeh1
  • Karam Karam1
  • Georges Aftimos4
  • Pierre Hani1
4 affiliations
  1. 1Department of Gastroenterology University of Balamand Beirut Lebanon balamand.edu.lb
  2. 2Department of Internal Medicine University of Balamand Beirut Lebanon balamand.edu.lb
  3. 3Department of Infectious Disease Saint George University Hospital Medical Center Beirut Lebanon
  4. 4Department of Pathology University of Balamand Beirut Lebanon balamand.edu.lb
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Abstract

Kaposi sarcoma (KS) is an angioproliferative malignancy associated with human herpesvirus‐8 (HHV‐8) infection and is strongly linked to immunosuppression, particularly in the setting of human immunodeficiency virus (HIV). Although cutaneous involvement is the most common presentation, visceral disease—especially within the gastrointestinal (GI) tract—may occur and is frequently underrecognized due to its often asymptomatic or nonspecific clinical manifestations. We report the case of a 41‐year‐old male who presented with severe, unexplained anemia without overt GI bleeding. Endoscopic evaluation revealed multiple violaceous, polypoid lesions throughout the stomach, duodenum, and colon. Histopathological examination, supported by immunohistochemical staining positive for CD31, CD34, and HHV‐8, confirmed the diagnosis of KS. Subsequent HIV testing was strongly reactive, with confirmatory HIV‐1 RNA testing subsequently requested. This case highlights the diagnostic challenge posed by GI KS and underscores the importance of maintaining a high index of suspicion in patients presenting with unexplained anemia. Early recognition through comprehensive endoscopic and histopathological evaluation is critical, as it may reveal previously undiagnosed HIV infection and significantly influence clinical management and prognosis.

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Cite

BibTeXRIS
BibTeX
@article{omar2026gastrointestinal,
  title = {{Gastrointestinal Kaposi Sarcoma as the Initial Presentation of Undiagnosed HIV Infection: A Case of Unexplained Anemia}},
  author = {Amir Omar and Tracy Zouein and Rayane Salameh and Karim Zodeh and Karam Karam and Georges Aftimos and Pierre Hani},
  journal = {Case Reports in Gastrointestinal Medicine},
  year = {2026},
  month = nov,
  doi = {10.1155/crgm/1526999},
  url = {https://doi.org/10.1155/crgm/1526999},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Gastrointestinal Kaposi Sarcoma as the Initial Presentation of Undiagnosed HIV Infection: A Case of Unexplained Anemia
AU  - Amir Omar
AU  - Tracy Zouein
AU  - Rayane Salameh
AU  - Karim Zodeh
AU  - Karam Karam
AU  - Georges Aftimos
AU  - Pierre Hani
PY  - 2026
DA  - 2026/11/03
JO  - Case Reports in Gastrointestinal Medicine
DO  - 10.1155/crgm/1526999
UR  - https://doi.org/10.1155/crgm/1526999
AB  - Kaposi sarcoma (KS) is an angioproliferative malignancy associated with human herpesvirus‐8 (HHV‐8) infection and is strongly linked to immunosuppression, particularly in the setting of human immunodeficiency virus (HIV). Although cutaneous involvement is the most common presentation, visceral disease—especially within the gastrointestinal (GI) tract—may occur and is frequently underrecognized due to its often asymptomatic or nonspecific clinical manifestations. We report the case of a 41‐year‐old male who presented with severe, unexplained anemia without overt GI bleeding. Endoscopic evaluation revealed multiple violaceous, polypoid lesions throughout the stomach, duodenum, and colon. Histopathological examination, supported by immunohistochemical staining positive for CD31, CD34, and HHV‐8, confirmed the diagnosis of KS. Subsequent HIV testing was strongly reactive, with confirmatory HIV‐1 RNA testing subsequently requested. This case highlights the diagnostic challenge posed by GI KS and underscores the importance of maintaining a high index of suspicion in patients presenting with unexplained anemia. Early recognition through comprehensive endoscopic and histopathological evaluation is critical, as it may reveal previously undiagnosed HIV infection and significantly influence clinical management and prognosis.
SN  - 2090-6528
SN  - 2090-6536
ER  -