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.
BACKGROUND
A bone marrow biopsy is frequently requested in the work-up of patients with human immunodeficiency virus (HIV) infection who present with fever and/or cytopenias in the search for opportunistic infections and malignancies.


METHODS
This is a retrospective review of the results of consecutive bone marrow biopsies performed at our institution over a three-year period on HIV-positive patients for the investigation of fever and/or cytopenias. Clinical data, haematological parameters, morphological features, Ziehl-Neelsen staining and microbiological culture results were analysed. The aim of the study was to determine the diagnostic yield of this investigation.


RESULTS
Sixty-three males and 84 female patients were included for analysis. The bone marrow biopsy gave a high diagnostic yield of 47% (70 patients) and a unique diagnosis in 33% (49 patients). Immune thrombocytopenic purpura and disseminated mycobacterial infections were the most common unique diagnoses made (14%, respectively), followed by malignancies (4%). In this cohort, four cases of primary bone marrow involvement by Hodgkin lymphoma and one case of involvement by non-Hodgkin lymphoma were diagnosed.


CONCLUSIONS
In our study group, a bone marrow biopsy was a useful investigation with a high diagnostic yield.
Department of Haematology, Groote Schuur Hospital and National Health Laboratory Service, University of Cape Town, Cape Town, South Africa. willem.vanschalkwyk@nhls.ac.za
W A
WA
van Schalkwyk
J
J
Opie
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N
Novitzky
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D001706:Biopsy; D001853:Bone Marrow / Q000382:microbiology / Q000473:pathology*; D005260:Female; D005334:Fever / Q000150:complications; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007970:Leukopenia / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013019:South Africa; D013921:Thrombocytopenia / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D055815:Young Adult