Abstract
From june to november 1992, we have studied 42 bone marrow aspirates from patients with AIDS, group IV-C (CDC classification, 1986) to assess the morphological, qualitative and quantitative, alterations due to this syndrome. The clinical criteria for the realization of these punctures were: persistent fever, anemia, leukopenia, thrombocytopenia or a combination of these abnormalities. In bone marrow aspirates we found hypocellularity predominance (71,4%), myelodysplasic alterations in all cases, as well as eosinophilia (19,0%), plasmacytosis (45,2%), lymphopenia (21,4%) and an increased number of macrophages (16,7%). In the peripheral blood we found anemia (81,0%), leukopenia (59,5%), neutropenia (42,9%), lymphopenia (88,0%), thrombocytopenia (33,3%) and pancytopenia (38,0%). The causes of these abnormalities are multiple: opportunistic infections, drug therapy, immunological mechanisms and the direct action of HIV on hemopoietic progenitor cells of the bone marrow and peripheral blood mature cells.
References
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8. CENTERS FOR DISEASE CONTROL. Classification system for human T-lymphotropic virus type III/ lymphadenopathy-associated virus infections. Ann. Intern. Med. 105:234-237, 1986.
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13. D'ONOFRIO, G.; MANCINI, S.; TAMBURRINI, E.; MANGO, G. & ORTONA, L. - Giant neutrophils with increased peroxidase activity. Another evidence of dysgranulopoiesis in AIDS. Am. J. Clin. Pathol. 87:584-591, 1987.
14. DUARTE, M.I.S.; OLIVEIRA, M.S. SHIKANAIYASUDA, M.A. MARIANO, O.N.; TAKAKURA, C.F.H.; PAGLIARI, C. & CORBETT, C.E.P. - Haemobartonella-like microorganism infection in AIDS patients: ultrastructural pathology (letter). J. Infect. Dis. 165:976-977, 1992.
15. FARHI, D.C.; MASON, U.G. & HORSBURGH, C.R. - The bone marrow in disseminated Mycobacterium avium intracellulare infection. Am. J. Clin. Pathol. 83:463-468, 1985.
16. FERRERAS FERRERAS, B. - Neurosida (I): aspectos generales. Mapfre Med. 3:249-264, 1992.
17. FERRERAS FERRERAS, B. - Neurosida (II): Manifestaciones neurológicas del SIDA. Mapfre Med. 4:29- 47,1993.
18. FOLKS, T.M.; KESSLER, S.W.; ORENSTEIN, J.M.; JUSTEMENT, J.S.; JAFFE, E.S. & FAUCI, A.S. - Infection and replication of HIV -1 in purified progenitor cells of normal human bone marrow. Science. 242:919-922, 1988.
19. FOLKS, T.M. - Human immunodeficiency virus in bone marrow: still more questions than answers. Blood. 77(8):1625-1626, 1991.
20. FRANCO, C.M.; HENDRIX, L.F. & LOKEY, J.L. - Bone marrow abnormalities in the acquired immunodeficiency syndrome (letter). Ann. Inter. Med. 101:275-276, 1984.
21. FRONTIERA, M. & MYERS, A.M. - Peripheral blood and bone marrow abnormalities in the acquired immunodeficiency syndrome. West. J. Med. 147:157- 160, 1987.
22. GANSER, A. - Abnormalities of hematopoesis in the acquired immunodeficiency syndrome. Blut. 56:49-53, 1988.
23. GARDENER, T.D.; FLANAGAN, P.; DRYDEN, M.S.; COSTELLO, C.; SHANSON, D.C. & GAZZARD, B.G. - Disseminated Mycobacterium avium - intracellulare infection and red cell hypoplasia in patients with acquired immunodeficiency syndrome. J. lnfect. 16:135-140, 1988.
24. GARTNER, S.; MARKOVITS, P.; MARKOVITZ, D.M.; KAPLAN, M.H.; GALLO, R.C. & POPOVIC, M. - The role of mononuclear phagocytes in HTLV III/LAV infection Science. 233:215-218, 1986.
25. GELLER, S.A.; MULLER, R.; GREENBERG, M.L. & SIEGAL, F.P. - Acquired immnodeficiency syndrome. Distinctive features of bone marrow biopsies. Arch. Pathol. Lab. Med.l09:138-141, 1985.
26. GILL, P.S.; RARICK, M.; BRYNES, R.K.; CAUSEY, D.; LOUREIRO, C. & LEVINE, A.M. - Azídothymidine associated with bone marrow failure in the acquired immnunodeficiency syndrome (AIDS). Ann. Intern. Med. 107:502-505, 1987.
27. HAWKINS, C.C.; GOLD, 1.W.M.; WHIMBEY, E.; KIEHN, T.E. BRANNON, P.; CAMMARATA, R.; BROWN, A.E. & ARMSTRONG, D. - Mycobacterium avium complex infections in patients with the acquired immunodeficiency syndrome. Ann. Intern. Med. 105:184-188, 1986.
28. HEYMAN, M.R. & RASMUSSEN, P. – Pneumocystis carinii involvement of the bone marrow in acquired immunodeficiency syndrome. Am. J. Clin. Pathol. 87(6):780-783, 1987.
29. HIRASUNA, J.D. - Disseminated Mycobacterium kansasii infection in the acquired immunodeficiency syndrome (AIDS) (letter). Ann. Intern. Med. 107 (5):784, 1987.
30. HROMAS, R.A. & MURRA Y, J.L. - Bone marrow in the acquired immunodeficiency syndrome (letter). Ann. Intern. Med. 101(6):877, 1984.
31. JAGADHA, V.; ANDRAVOLU, R.H. & HUANG, C. T, - Granulomatous inflammation in the acquired immunodeficiency syndrome, Am. J. Clin. Pathol. 84:598-602, 1985.
32. JOHNSON, P.C., KHARDORI, N.; NAJJAR, A.F.; BUTT, F.; MANSELL, P.W.A. & SAROSI, G.A. - Progressive disseminated histoplasmosis in patients with acquired immunodeficiency syndrome. Am. J. Med. 85:152-158, 1988.
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