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2006, Number 1

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Gac Med Mex 2006; 142 (1)

Usefulness of bone marrow microscopic examination in HIV-infected patients with pancytopenia.

Madrigal-Jiménez HM, Hernández-Rivera G

Language: Spanish
References: 39
Page: 13-17
PDF size: 56.72 Kb.


ABSTRACT

Introduction: The role of bone marrow examination in the diagnosis of prolonged fever in HIV infected patients, has been well established, but the importance of the morphological and etiological analysis, obtained in patients with coexisting pancytopenia, has not been adequately described.
Materials and methods: In a prospective study, we recruited 31 HIV- infected patients with coexisting pancytopenia, with or without fever. Bone marrow examination was performed in all cases. Other studies were done to confirm diagnosis.
Results: Parvovirus infection was observed in 5 patients, Histoplasma capsulatum in 4, Mycobacterium tuberculosis in 2, Mycobacterium avium complex in 3, HIV in 3, Salmonella typhi in 2, pneumonia and an unknown agent in 2 and intestinal infection and an unknown agent in 2. Only one patient was included in the following diagnostic etiologies: cytomegalovirus, trimethoprim sulfamethoxazole, Hodgkin’s disease, hypersplenism, acinetobacter, appendicitis with an unknown agent, E. coli, and hemophagocytic syndrome.
We obtained a probable diagnosis in 12 out of 31 patients (38.7%), using bone marrow examination.
Conclusion: In this subgroup of patients, the microscopic analysis of bone marrow is an important clinical approach that can lead to an early diagnosis of patients with and without fever.


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