title: A rare cause of acquired immune deficiency syndrome related pancytopenia.
abstract: A 21-year-old male with acquired immune deficiency syndrome, not on highly active antiretroviral treatment (HAART) was admitted after complaining of headache and intermittent diarrhea, found to have Cryptococcal meningitis. During the course of his hospitalization, patient developed pancytopenia. Anemia panel, serologies including Epstein barr virus, cytomegalovirus, and parvovirus were negative. Patient then developed high grade fever with elevated liver enzymes. Blood cultures, urine cultures, stool cultures, and repeat cerebrospinal fluid cultures remained negative. Patient subsequently developed skin lesions which on biopsy showed Kaposi's sarcoma, and upon endoscopy, noted to have gastrointestinal Kaposi's sarcoma involvement. Human herpes virus 8 was positive. Bone marrow biopsy revealed hemophagocytic lymphohistiocytosis. Despite having a concern for patient developing immune reconstitution syndrome which may worsen his meningitis, HAART was initiated and patient's symptoms improved including resolution of fevers and hematological as well as liver abnormalities. Kaposi's sarcoma improved as well.
authors: Department of Medicine, Albert Einstein College of Medicine , Jacobi Medical Center, Bronx, NY, USA.
authors: Su Bin
authors: SB
authors: Kim
authors: Department of Medicine, Albert Einstein College of Medicine , Jacobi Medical Center, Bronx, NY, USA.
authors: Makeardhwaj Sarvadaman
authors: MS
authors: Shrivastava
authors: Department of Hematology/Oncology, Albert Einstein College of Medicine , Jacobi Medical Center, Bronx, NY, USA.
authors: Marianna
authors: M
authors: Strakhan
keywords: Kaposi sarcoma; abnormal liver function test; acquired immune deficiency syndrome; hemophagocytic lymphohistiocytosis; pancytopenia