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2006, Número 1

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Gac Med Mex 2006; 142 (1)


Utilidad del estudio microscópico de medula ósea en pacientes con infección por VIH y pancitopenia

Madrigal-Jiménez HM, Hernández-Rivera G

Idioma: Español
Referencias bibliográficas: 39
Paginas: 13-17
Archivo PDF: 56.72 Kb.


RESUMEN

Introducción: El papel del examen de la medula ósea, en el diagnóstico de fiebre prolongada en pacientes con infección por VIH, ha sido bien establecido, pero aún no está bien estudiada la importancia de la información morfológica y etiológica obtenida en el subgrupo de pacientes con pancitopenia coexistente.
Material y métodos: En un estudio prospectivo reclutamos 31 pacientes con infección por VIH, con pancitopenia coexistente, con o sin fiebre. Se llevó a cabo en todos los casos el exámen microscópico de la médula ósea, además de otros estudios para concretar un diagnóstico específico.
Resultados: La infección por Parvovirus correspondió a cinco casos, Histoplasma capsulatum cuatro casos, Mycobacterium tuberculosis dos casos, complejo Mycobacterium avium tres casos, VIH en tres casos, Salmonella typhi dos casos, sin agente aislado y neumonía en dos casos, sin agente aislado e infección intestinal en dos casos. Hubo un solo caso de cada una de las siguientes etiologías: Citomegalovirus, trimetoprim-sulfametoxazol, Enfermedad de Hodgkin, hiperesplenismo, Acinetobacter, sin agente aislado y apendicitis por Escherichia coli, y síndrome hemofagocítico. Se logró el diagnóstico más probable mediante el análisis microscópico de la medula ósea en 12 de 31 pacientes (38.7%).
Conclusión: En este subgrupo de pacientes, el análisis microscópico de la medula ósea es un procedimiento apropiado, que permite además, un diagnóstico temprano en pacientes con y sin episodios febriles.


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