[Usefulness of bone marrow microscopic examination in HIV-infected patients with pancytopenia].
BACKGROUND
The role of bone marrow examination in the diagnosis of prolongedfever in HIV infected patients, has been well established, but the importance of the morphological and etiological analysis, obtained in patients with coexisting pancytopenia, has not been adequately described.


METHODS
In a prospective study, we recruited 31 HIV-infected patients with coexisting pancytopenia, with or withoutfever. Bone marrow examination was performed in all cases. Other studies were done to confirm diagnosis.


RESULTS
Parvovirus infection was observed in 5 patients, Histoplasma capsulatum in 4, Mycobacterium tuberculosis in 2, Mycobacterium avium complex in 3, HIV in 3, Salmonella typhi in 2, pneumonia and an unknown agent in 2 and intestinal infection and an unknown agent in 2. Only one patient was included in the following diagnostic etiologies: cytomegalovirus, trimethoprim sulfamethoxazole, Hodgkin's disease, hypersplenism, acinetobacter, appendicitis with an unknown agent, E. coli, and hemophagocytic syndrome. We obtained a probable diagnosis in 12 out of 31 patients (38.7), using bone marrow examination.


CONCLUSIONS
In this subgroup of patients, the microscopic analysis of bone marrow is an important clinical approach that can lead to an early diagnosis of patients with and without fever.
Departamento de Hematología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, México, DF México.
Héctor Manuel
HM
Madrigal-jiménez
Gabriela
G
Hernández-Rivera
D000293:Adolescent; D000328:Adult; D000368:Aged; D001856:Bone Marrow Examination; D005260:Female; D005334:Fever / Q000209:etiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000209:etiology* / Q000473:pathology*; D011446:Prospective Studies