Chandra Harish, Chandra Smita, Bhat Nowneet Kumar, Sharma Anita
Department of Pathology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
Hematology. 2011 Jul;16(4):255-7. doi: 10.1179/102453311X13025568941844.
The bone marrow examination in cases of infections may be non-specific but certain reactive changes may raise high index of suspicion of infections. The present study from a tertiary centre in the North Himalayan region of India describes the clinicohaematological profile and the changes associated with infections in the marrow. The study included all the cases of infections in which bone marrow examination was done during the period between January 2006 and July 2010. Leishmaniasis was the most common infection observed and most of the patients presented with fever along with anaemia and pancytopenia. Bone marrow examination showed predominantly transient myelodysplasia, plasmacytosis, and hemophagocytosis along with associated fibrosis and necrosis. Another important feature observed was accumulation of mature plasma cells around capillaries along with increased iron stores in the marrow. Thus, these features are important indicators of infections and should lead to their vigilant search in the patient.
感染病例的骨髓检查可能不具有特异性,但某些反应性变化可能会提高对感染的高度怀疑指数。来自印度北喜马拉雅地区一家三级中心的本研究描述了临床血液学特征以及骨髓中与感染相关的变化。该研究纳入了2006年1月至2010年7月期间进行骨髓检查的所有感染病例。利什曼病是观察到的最常见感染,大多数患者表现为发热伴贫血和全血细胞减少。骨髓检查显示主要为短暂性骨髓发育异常、浆细胞增多和噬血细胞增多,伴有相关的纤维化和坏死。观察到的另一个重要特征是成熟浆细胞在毛细血管周围积聚以及骨髓中铁储存增加。因此,这些特征是感染的重要指标,应促使对患者进行警惕的排查。