Diagnostic utility of bone marrow sampling in HIV positive patients.

Brook, M G; Ayles, Helen; Harrison, C. V.; Rowntree, Clare; Miller, R F

doi:10.1136/sti.73.2.117

Cited by 19 publications

(23 citation statements)

References 24 publications

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“…Although the features overlap with reactive/ dysplastic changes seen in HIV-infected patients (Bain, 1997;Brook et al, 1997), our results indicate that there are subtle morphological and immunohistochemical features that could be very helpful in the early diagnosis of this disease. The most significant changes were seen within the lymphoid component.…”

Section: Discussionmentioning

confidence: 75%

Pathology of bone marrow in human herpes virus‐8 (HHV8)‐associated multicentric Castleman disease

Bacon¹,

Miller²,

Noursadeghi³

et al. 2004

Br J Haematol

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SummaryHuman herpes virus-8 (HHV8)-associated multicentric Castleman disease (MCD) is an unusual systemic lymphoid hyperplasia induced by HHV8-infected B cells. Most cases develop in the background of human immunodeficiency virus (HIV) infection. Despite the haematological problems at presentation and the difficulties in the initial diagnosis, the bone marrow appearances of MCD have not been described. In this study we examined the pathology of bone marrow in MCD with a view to identify the features that may be helpful in early diagnosis. Bone marrow aspirates and biopsies from 13 cases of MCD (11 of which were HIV+) and 66 control bone marrow biopsies from HIV-infected cases were studied. The specimens were routinely processed and stained. Immunohistochemistry for HHV8, immunoglobulin light chains, B-cell and plasma-cell markers was performed. The most important features were the presence of characteristic MCD lymphoid follicles containing HHV8+ plasmablasts in three of 13 cases of MCD and scattered interstitial HHV8+ plasmablasts in 11 of 13 cases. In control cases, no such follicles were seen and interstitial HHV8+ plasmablasts were rarely detected (four of 66 cases). Our results suggest that the presence of HHV8+ plasmablasts within lymphoid follicles and/or interstitium of the bone marrow are helpful features for the early diagnosis of MCD.

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Section: Discussionmentioning

confidence: 75%

Pathology of bone marrow in human herpes virus‐8 (HHV8)‐associated multicentric Castleman disease

Bacon¹,

Miller²,

Noursadeghi³

et al. 2004

Br J Haematol

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“…Several authors have previously compared the clinical and laboratory findings of HIV patients with diagnostic vs. nondiagnostic bone marrow biopsies, in an attempt to identify predictive features. Some concluded that a bone marrow biopsy is most diagnostic in patients where fever and cytopenias coexist rather than either fever or cytopenias alone (Ciaudo, Doco‐Lecompte & Guettier, 1994; Brook et al. , 1997; Karstaedt et al.…”

Section: Discussionmentioning

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.…”

mentioning

confidence: 99%

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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“…Protozoal infection such as toxoplasmosis in HIV-infected patients has been reported to involve the bone marrow [147–149]. Bone marrow examinations of HIV-infected patients with pancytopenia have demonstrated Toxoplasma gondii within the cytoplasm of marrow cells belonging to myeloid lineages including macrophages, granulocytes and megakaryocytes [149, 150].…”

Section: Introductionmentioning

confidence: 99%

Neutropenia during HIV Infection: Adverse Consequences and Remedies

Shi¹,

Sims

Hanna³

et al. 2014

International Reviews of Immunology

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Neutropenia frequently occurs in patients with Human immunodeficiency virus (HIV) infection. Causes for neutropenia during HIV infection are multifactoral, including the viral toxicity to hematopoietic tissue, the use of myelotoxic agents for treatment, complication with secondary infections and malignancies, as well as the patient’s association with confounding factors which impair myelopoiesis. An increased prevalence and severity of neutropenia is commonly seen in advanced stages of HIV disease. Decline of neutrophil phagocytic defense in combination with the failure of adaptive immunity renders the host highly susceptible to developing fatal secondary infections. Neutropenia and myelosuppression also restrict the use of many antimicrobial agents for treatment of infections caused by HIV and opportunistic pathogens. In recent years, HIV infection has increasingly become a chronic disease because of progress in antiretroviral therapy (ART). Prevention and treatment of severe neutropenia becomes critical for improving the survival of HIV-infected patients.

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Diagnostic utility of bone marrow sampling in HIV positive patients.

Cited by 19 publications

References 24 publications

Pathology of bone marrow in human herpes virus‐8 (HHV8)‐associated multicentric Castleman disease

Pathology of bone marrow in human herpes virus‐8 (HHV8)‐associated multicentric Castleman disease

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

Neutropenia during HIV Infection: Adverse Consequences and Remedies

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