Gastrointestinal Kaposi Sarcoma and Multicentric Castleman Disease in an HIV-Positive Patient Following Liver Transplantation

Jessyka Soares Almeida Martins Luz, Kawã Maicky Aguiar Rodrigues, Carolina Devite Bittante Gonçalves, Thauana Barros De Gennaro, Patrícia Holanda Almeida, Lilian Amorim Curvelo, Celso Eduardo Lourenço Matielo, Carolina Frade Magalhães Girardin Pimentel Mota, Vanderlei Segatelli, Marcelo Bruno de Rezende and Luis Fernando Aranha Camargo

Department of Infectious Diseases, Hospital Israelita Albert Einstein, São Paulo, Brazil Department of Liver Transplant, Hospital Israelita Albert Einstein, São Paulo, Brazil Department of Pathology, Hospital Israelita Albert Einstein, São Paulo, Brazil

^*Correspondance to: Jessyka Soares Almeida Martins Luz 

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Abstract:

Background: Kaposi Sarcoma (KS) is the most frequent neoplasm associated with Human Herpesvirus 8 (HHV-8) in immunosuppressed individuals, with substantially higher incidence in solid organ transplant recipients. The coexistence of KS and Multicentric Castleman Disease (MCD) is uncommon and associated with greater clinical complexity. Case Presentation: We report a 21-year-old male liver transplant recipient with HIV co-infection who presented with prolonged fever (80 days), watery diarrhea, and 20 kg weight loss. Posttransplant complications included biliary and hepatic artery stenosis, late graft rejection, and poor adherence to immunosuppressive therapy. HIV was diagnosed in January 2025, with antiretroviral therapy interrupted due to gastrointestinal intolerance. On admission, CD4+ count was 235 cells/ mm3. Imaging revealed diffuse lymphadenopathy, splenomegaly, and rectal wall thickening. Histopathological and immunohistochemical evaluation confirmed gastrointestinal KS and HHV- 8-associated MCD. Treatment with doxorubicin and rituximab resulted in clinical improvement and symptom resolution. Conclusion: This case illustrates the diagnostic complexity of HHV-8-related diseases in patients with combined immunosuppression and highlights the importance of early recognition of visceral KS, even in the absence of cutaneous lesions.

Keywords:

Liver Transplantation

Cite the Article:

Almeida Martins Luz JS, Aguiar Rodrigues KM, Bittante Gonçalves CD, De Gennaro TB, Almeida PH, Curvelo LA, et al. Gastrointestinal Kaposi Sarcoma and Multicentric Castleman Disease in an HIV-Positive Patient Following Liver Transplantation. Ann Clin Case Rep. 2026; 11: 2849..