Bone marrow biopsy in the diagnoses of infectious and non-infectious causes in patients with advanced HIV infection

Tanaka, Paula Yurie; Hadad, David Jamil; Barletti, Silvia Cristina; Souza, Simone Aparecida de; Calore, Edenilson Eduardo

doi:10.1016/j.jinf.2006.06.007

Cited by 17 publications

(24 citation statements)

References 15 publications

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“…When comparing these conclusions with earlier similar studies, our diagnostic yield falls within the previously reported ranges of 27-42%. (Engels, Marks & Kazanjian, 1995;Benit, Nunez & De Gorgolas, 1997;Brook et al, 1997;Luther, Lakey & Larson, 2000;Pacios, Alcala & Ruiz-Serrano, 2004;Tanaka et al, 2006). Although our study was performed during the roll-out period of HAART in South Africa, which was initiated in March 2004, only 23% (n = 34) of our cohort were on this therapy.…”

Section: Discussionmentioning

confidence: 99%

“…A bone marrow biopsy may be a useful analytical tool in some of these patients, with the reported diagnostic yield ranging from 27% to 42% (Engels, Marks & Kazanjian, 1995; Brook et al. , 1997; Luther, Lakey & Larson, 2000; Pacios, Alcala & Ruiz‐Serrano, 2004; Tanaka et al. , 2006).…”

Section: Introductionmentioning

confidence: 99%

“…HIV-positive patients frequently present with pyrexia of unknown origin (PUO) and peripheral blood cytopenias, which may be caused by a dysregulated immune system, co-infection with TB, other disseminated opportunistic infections, malignancies, drugs or other haematological conditions. A bone marrow biopsy may be a useful analytical tool in some of these patients, with the reported diagnostic yield ranging from 27% to 42% (Engels, Marks & Kazanjian, 1995;Brook et al, 1997;Luther, Lakey & Larson, 2000;Pacios, Alcala & Ruiz-Serrano, 2004;Tanaka et al, 2006). Methods of identifying disseminated TB include microbiological cultures of the peripheral blood or bone marrow aspirate, histological examination of the trephine biopsy and Ziehl-Neelsen (ZN) staining of the bone marrow aspirate and trephine biopsy.…”

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confidence: 99%

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The diagnostic utility of bone marrow biopsies performed for the investigation of fever and/or cytopenias in HIV‐infected adults at Groote Schuur Hospital, Western Cape, South Africa

Schalkwyk

Opie

Novitzky

2010

Int J Lab Hematology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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The diagnostic utility of bone marrow biopsies performed for the investigation of fever and/or cytopenias in HIV‐infected adults at Groote Schuur Hospital, Western Cape, South Africa

Schalkwyk

Opie

Novitzky

2010

Int J Lab Hematology

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“…8 As the clinical spectrum of this disease has changed, it is appropriate to reevaluate the performance of BMB as a diagnostic tool in the HAART scenario. [9][10][11] The aim of the present study was to compare the diagnostic yield of BMB in HIV infected patients before and after HAART introduction.…”

Section: Introductionmentioning

confidence: 99%

Changing patterns of AIDS: impact on the indications and diagnostic yield of bone marrow biopsies

Morais¹,

Machado²,

Biasoli³

et al. 2010

Braz J Infect Dis

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After the advent of HAART, the clinical course of HIV infection has dramatically improved. Therefore, it seems appropriate to reevaluate the performance of bone marrow biopsy (BMB) as a diagnostic tool. The aim of the present study was to compare the reasons for performing a BMB and its diagnostic yield in HIV-patients before and after HAART. A total of 165 BMB specimens obtained from HIV-infected patients receiving care at the Hospital of Universidade Federal do Rio de Janeiro in two different periods (1986-1994 and 1999-2004) were analysed. The main reason for BMB examination in the fi rst period was fever (88%), which decreased in the second period (57%, p < 0.0001), when cytopenia (51%) was the leading reason for BMB, whereas in the fi rst period it accounted for only 30% (p = 0.008). A defi nitive diagnosis (infection, granulomas or lymphomas) was obtained in 28% of patients in the fi rst period and in 19% during the second period (p = 0.20). The diagnosis turned out as infections decreased from 16% in period 1 to 2% in period 2 (p = 0.003). Despite the the limitations in the evaluation of fever, the use of BMB must be considered on an individual basis, whenever less invasive alternatives have been exhausted, and should be complemented by a bone marrow aspiration for microbiological studies.

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“…Changes in bone marrow morphology associated with HIV-1 infection has been evaluated by various authors 1,5,8,28. These studies showed that certain findings are common to both HIV-1 and MDS.…”

Section: Discussionmentioning

confidence: 99%

Decreased Cd10 Expression in the Bone Marrow Neutrophils of Hiv Positive Patients

Vyver

Visser

2010

Mediterr J Hematol Infect Dis

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Background:HIV-1 infection is associated with various quantitative and qualitative changes in haemopoietic cells. Clear distinction between primary myelodysplastic syndrome (MDS) and secondary dysplasia may not always be possible. Adjunctive analyses used in the diagnosis of MDS include cytogenetics and flow cytometry (FCM). Much focus has been placed on establishing FCM guidelines aiding in the diagnosis of MDS, and to distinguish this condition from secondary dysplastic changes. One of the parameters often cited is the CD10 expression on the granulocyte population, as this marker denotes granulocytic maturation.Aims:To determine the expression level of CD10 on granulocytes in HIV positive patients.Methods:In total, 117 HIV-1 positive and 29 HIV-1 negative patients were included in this study. Bone marrow aspirate samples were evaluated in terms of morphological abnormality as well as CD10 expression on the granulocytic population.Results:The average CD10 expression among the HIV-1 positive patients were markedly reduced, at 18.4%, and 113 patients (96.6%) of these patients had expression levels below 50%.Discussion:Disease conditions causing secondary dysplasia, especially HIV-1 infection, is associated with a marked reduction in CD10 expression on the granulocyte population independent from the presence of myelodysplastic features. This marker is therefore of doubtful significance as a diagnostic tool in distinguishing between primary and secondary dysplasia.

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Bone marrow biopsy in the diagnoses of infectious and non-infectious causes in patients with advanced HIV infection

Cited by 17 publications

References 15 publications

The diagnostic utility of bone marrow biopsies performed for the investigation of fever and/or cytopenias in HIV‐infected adults at Groote Schuur Hospital, Western Cape, South Africa

The diagnostic utility of bone marrow biopsies performed for the investigation of fever and/or cytopenias in HIV‐infected adults at Groote Schuur Hospital, Western Cape, South Africa

Changing patterns of AIDS: impact on the indications and diagnostic yield of bone marrow biopsies

Decreased Cd10 Expression in the Bone Marrow Neutrophils of Hiv Positive Patients

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