scholarly journals HIV Myelopathy- A cross-sectional study of constellation of bone marrow findings in HIV/AIDS

Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 815-820
Author(s):  
Hemalatha Kuppan ◽  
Vanishri Ashok ◽  
Sridevi Hanaganahalli Basavaiah ◽  
Urmila Niranjan Khadilkar ◽  
Nirupama Murali
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Bone Marrow Aspiration ◽  
Unknown Origin ◽  
Absolute Lymphocyte Count ◽  
Cd4 Count ◽  
Clinical Indication ◽  
High Morbidity ◽  
Cross Sectional ◽  
Hiv Aids

Introduction and Aim: Haematological manifestations in HIV disease is common and can happen at any phase during the disease course. Anemia and thrombocytopenia are the most frequent hematologic abnormalities and are associated with high morbidity and mortality. The objective of current study was to observe and analyse various spectrum of bone marrow changes and haematological abnormalities in HIV/AIDS and to correlate findings with CD4 count.   Material and Methods: A total of 44 patients over a period of 5 years were included. Clinical findings, hematological profile, bone-marrow aspirate, biopsy findings and CD4 count of these patients were documented. The association between absolute lymphocyte count (ALC) and CD4 count were further established.   Results: The most common clinical indication for bone-marrow aspiration and trephine biopsy was pancytopenia (47.3%), pyrexia of unknown origin (15.1%), and unresolving hepatosplenomegaly (13.6%). Anemia (72.7%) was commonest haematological abnormality. Bone marrow aspirate was normocellular in majority of patients. Marrow findings were correlated with CD4 count and were found to be statistically significant. Tri-lineage dysplasia was observed in 9.1% of patients, and megakaryocytic dysplasia being the commonest(61.4%). Histiocytic aggregates (27.3%) were noted among which 6.8% showed acid fast bacilli in Ziehl-Neelsen stain. Fungal stains revealed histoplasmosis in 4.5% patients.   Conclusion: There was a strong negative association between presence of anemia and dysplasia and CD4 count. When CD4 was <200/µL and ALC<1000/mm3, presence of anemia and dysplasia affecting various cell lines were commonly observed; therefore, can be used as indicators to assess the severity of the disease.

scholarly journals Manifestations of Bone Marrow Abnormalities of HIV/AIDS Patients

2021 ◽  
Vol 7 (3) ◽  
pp. 119-127
Author(s):  
Dr. Soumya Kanti Pramanik ◽  
◽  
Dr. Mamata Guha Mallick Sinha ◽  
Keyword(s):  
Bone Marrow ◽  
Opportunistic Infections ◽  
Complete Blood Count ◽  
Bone Marrow Aspiration ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Aids Patients ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Hiv Aids

Background: Human immunodeficiency virus can involve almost any organ system. Anemia is themost common hematological manifestation in HIV/AIDS patients. Bone marrow changes includevarying degrees of dysplasia in one or more cell lines, plasmacytosis, opportunistic infections andhematological malignancies. There are only a few studies where hematological manifestations ofHIV/AIDS patients had been described. Materials and Methods: 100 HIV positive patients, agedbetween 12-65 years were enrolled in this hospital-based cross-sectional study. The study wasconducted from March 2016 to March 2018. A complete blood count, CD4 counts were done, besidesa thorough history and clinical examination. HIV positive patients were classified as those havingAIDS and Non-AIDS, according to NACO criteria. Written informed consent was taken from patientsand bone marrow aspiration was done. Results: Total number of patients included in the study was100. We were able to do a CD4 count of 91 patients. As per criteria, out of 91 patients, 37 cases hadAIDS. The most common hematological abnormality was anemia, seen in 95.45%of patients. Bonemarrow was normocellular in 86.48% of AIDS and 85.18% of non-AIDS, hypocellular in 8.10% ofAIDS and 9.25%o f non- AIDS, hypercellular in 5.40% of AIDS and 5.55% of non-AIDS patients.Dysplasia was statistically and significantly associated with anemia. The commonest dysplasticfeatures are seen in the granulocytic and erythroid series. L.D. bodies were seen in 2 cases andHistoplasma was found in one case. Conclusion: Normocytic normochromic anemia was the mostcommon peripheral smear finding. Hypocellular bone marrow was more common than hypercellularmarrow in an advanced stage of the disease. Dysplastic changes were more common in AIDS thanNon-AIDS. Granulocytic dysplasia was the most common type of dysplasia. There was evidence ofopportunistic infections and gelatinous transformation were detected in our study.

scholarly journals Bone marrow aspiration versus trephine biopsy: diagnostic value of both modalities when done simultaneously.

2021 ◽  
Vol 28 (12) ◽  
pp. 1844-1849
Author(s):  
Muhammad Ihtesham Khan ◽  
Asmara Rasheed ◽  
Sami Iqbal
Keyword(s):  
Bone Marrow ◽  
Qualitative Data ◽  
Bone Marrow Aspirate ◽  
Bone Marrow Aspiration ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Trephine Biopsy ◽  
Cross Sectional ◽  
The Mean ◽  
Study Setting

Objective: To compare diagnostic value of bone marrow aspiration and bone marrow trephine in reaching to final diagnosis. Study Design: Cross Sectional Descriptive study. Setting: Pathology Department of Khyber Teaching Hospital, Peshawar. Period: December 2015 to September 2016. Material & Methods: About 199 bone marrow procedure were done during study period. Nine cases were excluded because their trephine biopsy specimen was not available. So, the remaining 190 cases, of both the sexes and age above 2 years were included. Bone marrow aspiration and trephine biopsy were obtained from all the patients, and examined. Qualitative data was determined by frequency and percentages. Quantitative data was shown by mean and standard deviation. Results: 190 cases were included in the study. The mean age of the sample was 40 ±11.5 SD years (range: 2 to 81 years). Bone marrow aspirate alone could diagnose 139 (72.8%) cases while trephine biopsy alone was sufficient to diagnose 12 (6.3%) cases. Both the modalities showed similar diagnosis in 39 (20.9%) cases. Conclusion: Leukemias, anemias, and idiopathic thrombocytopenic purpura can be diagnosed by marrow aspiration alone. Aplastic anemia and myelofibrosis need marrow trephine for diagnosis. Both these modalities are important lest any diagnoses should be missed.

scholarly journals Suicidal ideation, psychopathology and associated factors among HIV-infected adults in Indonesia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Youdiil Ophinni ◽  
Adrian ◽  
Kristiana Siste ◽  
Martina Wiwie ◽  
Gina Anindyajati ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Single Point ◽  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Cd4 Count ◽  
Depression Symptoms ◽  
Early Screening ◽  
Cross Sectional ◽  
Aids Epidemic ◽  
Hiv Aids

Abstract Background Suicidal behavior is a prevalent psychiatric emergency in HIV-infected adults. Detection of suicidal ideation is important in planning early psychiatric intervention and optimizing HIV/AIDS management. Characterization of suicidal ideation among HIV-infected adults is crucial; however, practically there is no data in Indonesia, the country with the second largest burden of HIV/AIDS epidemic in Asia. This study aims to identify suicidal ideation and analyze the associated psychopathology and determining factors among HIV-infected adults in Indonesia. Methods An observational cross-sectional study was conducted among HIV-infected adults aged 18–65 years old receiving antiretroviral therapy (ART). Measurement using Symptom Checklist-90 (SCL-90) was performed to assess the existing psychopathology. Firth’s penalized logistic regression analysis was performed to identify factors associated with suicidal ideation. Results A total of 86 subjects were recruited. Most subjects were male (65.1%), median age was 35 years, and median latest CD4 count was 463 cells/μl. Lifetime suicidal ideation was identified in 20 subjects (23.3%). Mean SCL-90 T-score for depressive and anxiety symptoms were both significantly higher among subjects with suicidal ideation (M = 60.75, SD = 12.0, p = 0.000 and M = 57.9, SD = 2.8, p = 0.001, respectively) compared to those without. Bivariate analyses showed that lifetime suicidal ideation was associated with depressive and anxiety symptoms, non-marital status, CD4 count < 500 cells/μl, and efavirenz use. Multivariate analysis identified that a single-point increase in SCL-90 depression symptoms score (AOR 1.16, 95% CI 4.5–123.6, p = 0.000) and efavirenz use (AOR 5.00, 95% CI 1.02–24.6, p = 0.048) were significant independent factors related to suicidal ideation. Conclusion Suicidal ideation is commonly found among Indonesian HIV-infected adults on ART. Depressive symptoms and efavirenz use are independent factors related to the presence of suicidal ideation. Thus, early screening of psychopathology as well as substitution of efavirenz with other ART regiment are recommended to prevent suicide and improve HIV/AIDS management outcome.

Utility of bone marrow examination for workup of fever of unknown origin in patients with HIV/AIDS

2015 ◽  
Vol 68 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Andrés E Quesada ◽  
Ashok Tholpady ◽  
Audrey Wanger ◽  
Andy N D Nguyen ◽  
Lei Chen
Keyword(s):  
Bone Marrow ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Hiv Aids

scholarly journals Opportunistic Infections and Associated Factors among HIV/AIDS Patients taking Ante-Retroviral Therapy at Selected Hospitals in Sidama Zone, Southern Ethiopia: A facility-based cross-sectional study

2019 ◽  
Author(s):  
Demelash Wachamo ◽  
Fisseha Bonja
Keyword(s):  
Associated Factors ◽  
Opportunistic Infections ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Sectional Study ◽  
Aids Patients ◽  
Cross Sectional ◽  
Hiv Aids

Abstract Background Opportunistic infections are late complications of HIV infection is the depletion of the immune system. It is a major public health problem and high morbidity AIDS patients die of AIDS-related infections in developing countries like Ethiopia. Identification of opportunistic infections (OIs) is important to develop a specific intervention. Therefore, this study aimed to assess the burden and associated factors of opportunistic infections.Method A facility-based cross-sectional study was conducted on 420 randomly selected HIV/AIDS patients taking anti-retroviral therapy. Data was collected from selected hospitals in Sidama Zone based on population proportion to size. Data was collected by a pre-tested questionnaire and a pre-tested checklist from the medical records of patients. Data entry and analyzed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05.Result The magnitude of opportunistic infections was 39.6%. Major identified OIs was oral candidacies 23.2%, recurrent bacterial pneumonia 21.5%, Herpes zoster 6.3%, and Pulmonary Tuberculosis 6.0%.The magnitude of opportunistic associated with; older age [AOR=2.69, 95% CI: 1.33-5.43], No formal education [AOR=3.12, 95% CI: 1.06-9.25], Low monthly income [AOR=2.27, 95%CI:1.35-3.83], initial CD4 count less than 200 cells/mm3 [AOR=1.91, 95% CI:1.05-3.46), WHO clinical stage II [AOR=2.43, 95% CI:1.34-4.42] and stage III and IV [AOR=4.27, 95% CI: 2.12-8.59], had no extra medicine additional to ART (prophylaxis) had [AOR= 5.91, 95% CI: 3.31-10.56], who interrupt ART medicines [AOR=2.03, 95% CI: 1.09- 3.80] and Khat chewing [AOR=5.48, 95% CI: 2.32-12.96] when compared to their counterparts.Conclusions The overall magnitude of opportunistic infections was high when compared with other studies. Health officials and clinicians need to give attention on the strengthening of the provision if ART with prophylaxis on early-stage and adhrerence, implementation of the TB/HIV collaboration activity, and early initiation of ART to reduce opportunistic infections.

scholarly journals Undernutrition and associated factors among adult HIV/AIDS patients receiving antiretroviral therapy in eastern zone of Tigray, Northern Ethiopia: a cross-sectional study

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Tsegu Hailu Gebru ◽  
Haftea Hagos Mekonen ◽  
Kbrom Gemechu Kiros
Keyword(s):  
Antiretroviral Therapy ◽  
Associated Factors ◽  
Preventive Therapy ◽  
Cd4 Count ◽  
Clinical Staging ◽  
Northern Ethiopia ◽  
Aids Patients ◽  
Cross Sectional ◽  
Eastern Zone ◽  
Hiv Aids

Abstract Background Undernutrition and HIV/AIDS are highly prevalent in sub-Saharan Africa, Ethiopia inclusive as linked in a vicious cycle. Thus, several studies have documented that undernutrition among HIV/AIDS patients increases the risk of mortality, decrease survival rates, affect the overall clinical outcome and quality of life. Despite this fact, information about the burden of undernutrition and associated factors among adults receiving antiretroviral therapy is lacking in the particular study area. Hence, this study aimed to examine the prevalence of undernutrition and associated factors among adult HIV/AIADS patients receiving antiretroviral therapy patients in Eastern Zone of Tigray, Northern Ethiopia. Methods A cross-sectional research design was adopted in data collection while systematic sampling technique was employed to sample and select the study subjects. A structured questionnaire was used to collect information from 394 study subjects through face to face method. Also, data on demographics, laboratory and anthropometric variables were collected from each selected patients sampled. The data collected were entered and analyzed using SPSS version 22.. Bivariate and multivariable logistic regression analysis with 95% confidence interval were used to find factors associated with undernutrition. The adjusted odds ratio was calculated to show the strength of the association. Variables with p-value of < 0.05 were considered statically significant. Results The mean age of the respondents was 41 (± 10). Out of 394 study respondents, about 42.9% of them were undernourished (95% CI: 37.8–47.7). Respondents who had CD4+ count less than 200 cells/μl (AOR = 1.84; 95% CI: 1–3.36), being advanced clinical staging (AOR = 3.6; 95% CI: 2.11–6.18), and not taking co-trimoxazole preventive therapy (AOR = 2.38; 95% CI: 1.21–4.6) were independently associated with undernutrition. Conclusion The result of this study indicated that the prevalence of undernutrition was high. Respondents with advanced clinical stage of CD4+ count less than 200 cells/ul and those that were not taking co-trimoxazole preventive therapy was found to be positively associated with undernutrition. Therefore, the implementation of nutritional programs is very crucial to improve the nutritional status of HIV/AIDS patients in the particular study.

scholarly journals Comparison of KAtex, Bone Marrow Aspiration and DAT for the Diagnosis of Visceral Leishmaniasis

2019 ◽  
Vol 6 (1) ◽  
pp. 12-15
Author(s):  
Ishrat Sharmin ◽  
AKM Quamruzzaman ◽  
Rezina Parveen ◽  
M Abdulah Yusuf ◽  
Rashida Akter Khanam
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Bone Marrow Aspiration ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Kala Azar ◽  
History Of ◽  
One Year

Background: Newly developed KAtex test can be used as a non invasive tool for diagnosis of Kala-azar. Objectives: The aim of the present study was to compare KAtex, Bone marrow aspiration and DAT to diagnose VL. Methodology: This cross-sectional study was carried out in the Department of Microbiology at Dhaka Medical College, Dhaka, Bangladesh in collaboration with the Department of Parasitology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh for a period of one year. Clinically suspected Kala-azar (VL) cases of different age and sex attending IEDCR, Dhaka from different Kala-azar endemic areas of Bangladesh were selected for this study. Patients having fever for more than 2 weeks, with or without splenomegaly, having history of loss of body weight following onset of fever were clinically suspected as Kala-azar cases. Microscopy and culture was performed in bone marrow (BM). KAtex was performed with urine sample. Agglutination of sensitized latex indicated presence of Leishmania donovani antigen in urine and thereby visceral leishmaniasis. No agglutination indicates absence of antigen in urine. DAT was done with serums of all cases. Result: Among 130 clinically suspected VL cases, 70 (53.85%) cases were BM positive and 60(46.15%) cases were BM negative. All the 70 BM positive cases were positive by KAtex and DAT. Among 60 BM negative cases, 15 were positive by KAtex and 23 were positive by DAT. The sensitivity of KAtex was 100.0% and specificity was 75.0%. The sensitivity of DAT was 100.0% and specificity is 61.6%. Conclusion: In conclusion, KAtex test is a good diagnostic tool for the detection of VL in comparison with DAT. Bangladesh Journal of Infectious Diseases, June 2019;6(1):12-15

A Case of Fulminant Myelodysplastic Syndrome Versus Acute Erythroleukemia Variant.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4900-4900
Author(s):  
Fermina M. Mazzella
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspirate ◽  
Reticulocyte Count ◽  
Bone Marrow Aspiration ◽  
Chronic Fatigue ◽  
Red Cell ◽  
Significant Past Medical History ◽  
Normal Limits ◽  
Rare Instance

Abstract Case: A 73 year old male with no significant past medical history presented with chronic fatigue. A routine CBC revealed an H/H of 6.8/19, MCV 103, WBC 4,100 and platelet count 92,000. Reticulocyte count was 0.6%. Serum iron, B12 and red cell folate studies were within normal limits. A bone marrow aspiration and biopsy were performed. Bone Marrow Findings: The bone marrow aspirate showed an M:E ratio of 1.8:1, with 33% erythrocytic elements. There was markedly left shifted erythropoiesis, with 57% of erythrocytic precursors being pronormoblasts. 1.2% blasts were present. Moderate erythrocytic dysplasia was present, with mild granulocytic and megakaryocytic changes. Vacuolated pronormoblasts were readily identified. No ringed sideroblasts were present. A diagnosis of MDS, NOS was rendered. No cytogenetics were obtained. Follow-up: The patient was transfused 4 units of packed red cells. Due to the patient’s rapidly deteriorating condition, comfort measures only were provided. The patient died 2.5 weeks after the bone marrow procedure. No autopsy was performed. The cause of death was listed as MDS. Discussion: This case is an extremely rare instance of left shifted erythropoiesis in the absence of the requisite number of erythrocytic elements for consideration of acute erythroleukemia (50%). By current definitions, this is an example of a fulminant MDS. However, this case does beg the question of whether or not pronormoblasts should be included in the assessment of malignant disorders of bone marrow.

scholarly journals UNCOMMON PRESENTATION OF A COMMON DISEASE AS PUO

2020 ◽  
pp. 51-52
Author(s):  
Y.V.S. Prabhakar ◽  
Ponnaganti Vasundhara
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Aspiration ◽  
Unknown Origin ◽  
Common Disease ◽  
Peripheral Smear ◽  
Laboratory Findings ◽  
Pyrexia Of Unknown Origin ◽  
Uncommon Presentation ◽  
Blood Smears ◽  
Peripheral Blood Smears

We report a case of pyrexia of unknown origin in a 35 yr old male . He presented to us with fever since 2 months which was associated with chills and rigor . He is non alcoholic , non smoker . Mild Hepatosplenomegaly was found on initial physical examination. Before he was referred to our hospital, he was investigated in outside hospital . The serial Rapid Diagnostic Test and microscopic peripheral blood smears for plasmodium were negative . He was treated symptomatically . In view of non subsiding fever patient was referred to higher centre . He presented to our institute for further evaluation . His laboratory findings found pancytopenia. Bone marrow aspiration(BMA) was done. BMA showed Gametocytes of P. falciparum. The presence of gametocytes of P.Falciparum in the bone marrow ,not in peripheral smear and presenting as PUO is rare .

scholarly journals A Clinico-Haematological Study of Causes of Pancytopenia

2021 ◽  
Vol 10 (40) ◽  
pp. 3533-3537
Author(s):  
Arvind Chouhan ◽  
Fuzail Ahmad ◽  
Manisha Jain
Keyword(s):  
Bone Marrow ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Cross Sectional ◽  
Smear Examination ◽  
Cellular Components ◽  
Haematological Study

BACKGROUND This is a clinic-haematological study, conducted in Sidhanta Hospital, Bhopal, to identify the causes of pancytopenia. Out of total 1200 cases of complete hemograms, 56 cases were categorized as pancytopenias, and out of these, 24 cases were subjected to bone marrow examination. The remaining 32 cases of pancytopenia, were put on periodic follow up with peripheral blood smear examination, based on clinical data. Pancytopenia is the simultaneous presence of anaemia, leucopenia and thrombocytopenia that may result from various disease processes, involving the bone marrow primarily or secondarily. Pancytopenia is reduction in all the three cellular components of the blood, namely red blood cells (RBCs), leucocytes (WBCs) and platelets. It is a common entity which is encountered by practitioners. The presentation is in the form of cytopenias leading to infections, anaemia, or bleeding manifestations. All the cases of pancytopenia need a through approach to reach to the cause of the same so that it can be managed in the best possible manner. Cytopenias are reduction in any of the three cellular components of the blood i.e. RBCs, WBCs or platelets. It can be reduction in two cellular components (bicytopenia) or a reduction in all the three cellular components (pancytopenia). In bicytopenia, the most common combination to be seen is anaemia and thrombocytopenia, whereas the least common is leucopenia with thrombocytopenia. (1) For practical purposes, it should have haemoglobin < 10 g%, absolute neutrophil count < 1,500/cumm and platelets < 1,00,000/cumm. It is labelled as severe when the three values are < 7 g%, < 500/cumm and < 20,000/cumm respectively. The purpose of this study was to find out different causes of pancytopenia and the use of bone marrow examination in evaluation of pancytopenia. METHODS This is a cross sectional study, conducted exclusively in the Department of Medicine, at a tertiary care hospital, in Bhopal from August 2019 to December 2019. A total of 56 cases of pancytopenia were analysed with clinico-haematological features. Criteria for diagnosis of pancytopenia were: Haemoglobin less than 10 gm/dl, TLC less than 4000/mm3 and platelet count less than 1,00,000/mm3. We have correlated the complete hemogram findings with bone marrow examination (if required) and peripheral smear examination in order to analyse the root cause of every case of pancytopenia. Pancytopenia is a haematological entity, we have to analyse the cause of it in order to find out the correct diagnosis and treat the patient accordingly. Bone marrow examination is useful in the investigation of PUO (pyrexia of unknown origin), as it leads to an etiological diagnosis in many of the cases. RESULTS In these 56 cases, only 24 cases (42.85 %) were subjected for bone marrow examination. Commonest cause of pancytopenia was episode of viral fever constituting 28 cases (50 %). CONCLUSIONS In cases of PUO, bone marrow examination is a very useful investigation. In cases diagnosed as idiopathic thrombocytopenic purpura (ITP), when the patient does not show improvement in counts, a repeat bone marrow examination should be done, as very rarely; acquired amegakaryocytic thrombocytopenia may be the cause. Though bone marrow examination is an absolute indication in cases of pancytopenia, it is important to wait for at least 2 – 3 weeks, and do a repeat hemogram, especially in cases of viral fever where the counts usually improve after fever subsides. KEY WORDS Pancytopenia, Bone Marrow, Viral Fever

Sign in / Sign up

Export Citation Format

Share Document