Hematological abnormalities are frequent among human immunodeficiency virus (HIV)-infected patients and may be directly attributable to the virus or may be caused by opportunistic infections, neoplasms or drugs that cause bone marrow suppression or hemolysis. Pure red cell aplasia (PRCA) is an uncommon hematological disorder that causes anemia. We report a 37-year-old male with HIV infection who developed PRCA 6 weeks after commencing Zidovudine and recovered following cessation of the drug. This is the first case of Zidovudine-induced PRCA reported from the Indian subcontinent.
A 48-year-old thin-built (BMI of 18.2 kg/sq.m.) female was admitted with history of recurrent episodes of cough with expectoration for the past 10 years, dyspnoea and fatiguability for the past 5 years, and pedal oedema for the past 10 days. There was no history of fever, postnasal drip, gastro-oesophageal reflux, anorexia, weight loss, chest pain, paroxysmal nocturnal dyspnoea, orthopnoea or palpitations. Also, there was no history of tuberculosis in the past. The patient was not a smoker.On general examination, her vitals were stable. The patient had bilateral pitting pedal oedema, coarse crepitations in the right mammary area, loud S2 and ejection systolic murmur in the pulmonary area.Basic laboratory evaluation showed complete blood profile, renal and liver functions to be normal. Chest X-ray showed evidence of right middle lobe bronchiectasis [Table/ Fig-1]. Sputum culture showed no growth, and stain for acid-fast bacilli (AFB) was negative. The patient was also negative for HIV and hepatitis serological tests. Pulmonary function test showed evidence of small airway obstruction. Bronchoscopy findings were normal, except for secretions in the right middle lobe bronchus.
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