LETTER
Esophageal Ulcers in AIDS
Louis-Jean Couderc, MD;
Evelyne Balloul, MD; and
Isabelle Caubarrere, MD
15 May 1996 | Volume 124 Issue 10 | Page 928
TO THE EDITOR:
Wilcox and colleagues [1] documented the high prevalence of idiopathic esophageal ulcers in patients with human immunodeficiency virus (HIV) infection and suggested that steroids be used in these patients. We previously reported that thalidomide was beneficial for esophageal ulceration and the HIV wasting syndrome [2, 3]. With treatment, the symptoms of aphthous ulceration, myalgia, and fever abated within 2 weeks. The patients required prolonged maintenance therapy because of recurrence when the daily thalidomide dose was tapered from 100 mg to 50 mg. No neurologic adverse effects occurred, although patients were treated simultaneously with azidothimidine. We suggest that thalidomide could be used as a first-line treatment for HIV-infected patients with idiopathic esophageal ulcers. Because of the well-known adverse effects of thalidomide, the use of the drug should be restricted to male patients who do not have peripheral neuropathy.
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Author and Article Information
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Hopital Foch; 92150 Suresnes, France
1. Wilxox CM, Schwartz DA, Clark WS. Esophageal ulceration in human immunodeficiency virus infection. Causes, response to therapy, and long-term outcome. Ann Intern Med. 1995; 122:143-9.
2. Couderc LJ, Mathez D, Leibowitch J, Autran B, Caubarrere I. Traitement prolonge par thalidomide chez un malade infecte par le VIH [Letter]. Presse Medicale. 1995; 24:40.
3. Couderc LJ, Autran B, Mathez D, Zucman D, Leibowitch J, Caubarrere I. Thalidomide in wasting syndrome of AIDS [Abstract]. Fourth European Conference on Clinical Aspects and Treatment of HIV Infection, Milan, Italy; March 1994.
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