Abstract
Acute acalculous cholecystitis (AAC) usually occurs in the elderly and in those with severe preexisting pathological conditions. However, there have recently been reports of AAC in relatively young immunosuppressed patients, such as those with acquired immunodeficiency syndrome (AIDS). We report here a 27-year-old woman with AAC who received an emergent cholecystectomy. Although anti-human immunodeficiency virus antibody (anti-HIV) was not detected, a decrease in the CD4/CD8 ratio in sera was found. This rare case of AAC in a patient with decreased CD4/CD8 ratio who showed no other related diseases suggests that surgeons should keep in mind the possible presence of immunosuppression in this condition.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Savoca PE, Longo WE, Zucker KA. The increasing prevalence of acalculous cholecystitis in outpatients. Results of a 7-year study. Ann Surg 1990;211:433–437.
Roslyn JJ, Pitt HA, Mann L, et al. Parenteral nutrition-induced gallbladder disease: A reason for early cholecystectomy. Am J Surg 1984;148:58–63.
Saraux JL, Lenoble L, Toublanc M, et al. Acalculous cholecystitis and cytomegalovirus infection in a patient with AIDS (letter). J Infect Dis 1987;155:829.
Wind P, Chevallier JM, Jones D, et al. Cholecystectomy for cholecystitis in patients with acquired immune deficiency syndrome. Am J Surg 1994;168:244–246.
Farman J, Brunetti J, Baer JW, et al. AIDS-related cholangiopancreatographic changes. Abdomi Imag 1994;19:417–422.
Adolph MD, Bass SN, Lee SK, et al. Cytomegaloviral acalculous cholecystitis in acquired immune deficiency syndrome patients. Am J Surg 1993;59:679–684.
Keshavjee SH, Magee LA, Mullen BJ, et al. Acalculous cholecystitis associated with cytomegalovirus and sclerosing cholangitis in a patient with acquired immune deficiency syndrome. Can J Surg 1993;36:321–325.
Fike DJ. Cellular assays. In: Sheehan C (ed) Clinical immunology: Principles and laboratory diagnosis. Philadelphia: JB Lippincott, 1990:194–195.
Datiles TB, Humphrey RL. Immune deficiency. In: Sheehan C (ed) Clinical immunology: Principles and laboratory diagnosis. Philadelphia: JB Lippincott, 1990:305–317.
Keddie NC, Gough AL, Galland RB. Acalculous gallbladder disease: A prospective study. Br J Surg 1976;63:797–798.
Glenn F. Surgical management of acute cholecystitis in patients 65 years of age and older. Ann Surg 1981;193:56–59.
Johnson LB. The importance of early diagnosis of acute acalculous cholecystitis. Surg Gynecol Obstet 1987;164:197–203.
Long TN, Heimbach DM, Carrico CJ. Acalculous cholecystitis in critically ill patients. Am J Surg 1978;136:31–36.
Petersen SR, Sheldon GF. Acute acalculous cholecystitis. A complication of hyperalimentation. Am J Surg 1979;138:814–817.
Glenn F, Becker CG. Acute acalculous cholecystitis. An increasing entity. Ann Surg 1982;195:131–136.
Bryant NJ. Specific Immunity. In: Bryant NJ (ed) Laboratory immunology and serology. 3rd ed. Toronto: Serological Service 1992:34–36.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ikeda, S., Kimura, W., Futakawa, N. et al. Acute acalculous cholecystitis with a decrease in CD4/CD8 ratio. J Gastroenterol 32, 268–272 (1997). https://doi.org/10.1007/BF02936381
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02936381