A 39-year-old male with four months of severe epigastric pain, nausea, early satiety, vomiting, soft stools, weight loss of 7 kg, asthenia and adynamia.
Two weeks before admission, the patient developed progressive edema of the lower limbs and an episode of vomiting.
She had been treated for 18 years for syphilis.
The patient was admitted to hospital with mucocutaneous anasarca and mucocutaneous stiffness.
Epigastric pain without masses or visceromegaly with ascitic wave was observed.
Placetic plaque macules were observed in the hard palate, the floor of the tongue and glans of vascular aspect, non-bleeding, with laceration of the balano-preputial groove and grade II edema.
HIV was documented by ELISA, confirmed by Western Blot, in addition to hypoproteinemia without clear etiology; cardiac, hepatic, renal or nutritional causes were ruled out.
Contrast abdominal tomography reported polypoid thickening of the gastric walls and upper endoscopy showed extensive diffuse gastric lesion multinodular and exophytic, predominantly in the body and fundus.
The histopathological study of the gastric biopsy showed a marked proliferation of foveal cells and deep intussusceptions replacing the original oxyntic mucosa.
At the lamina propria level KS was confirmed with immunostaining for human herpes virus type 8 (HHV8).
Antiretroviral therapy was initiated and was scheduled for later initiation of chemotherapy with an anthrax.
