Rodríguez J N, Diéguez J C, Moreno M V, Aguayo D M, Vega M D, Conde J, Prados D
Servicio de Hematologia, Hospital Juan Ramón Jiménez, Huelva.
Rev Clin Esp. 1996 Apr;196(4):213-6.
A bone marrow investigation is a common examination in HIV infected patients for the study of cytopenia, febrile syndromes of unknown origin and extension of neoplastic disorders. A study was made of bone marrow specimens from 35 patients with advanced HIV infection (stage IC or C, CDC, Atlanta) for morphologic and culture investigations (aerobes, anaerobes, fungi, and mycobacteria). In nine patients cytopenia accounted for the investigation of bone marrow specimens (9 aspirates and 3 biopsies); in only two cases did the investigation orientate towards a possible etiology: in the first patient a parvovirus B19 infection and in the second patient a hemophagocytic syndrome. In twenty-five patients the bone marrow specimen was studied because of fever of unknown origin (23 aspirates and 10 biopsies) and only in one case was the identification of Mycobacterium tuberculosis obtained. The other patient was studied for lymphoma staging and aspirate and biopsy examinations were normal. A high percentage of patients had eosinophilia, plasmacytosis, increased iron reserves, fibrosis, and changes consistent with myelodysplasia. In conclusion, in our experience the investigation of bone marrow specimen was of little help to clarify the possible etiology of cytopenia and febrile syndromes of unknown origin in patients with advanced HIV infection.
骨髓检查是对HIV感染患者进行的一项常见检查，用于研究血细胞减少、不明原因的发热综合征以及肿瘤性疾病的扩展情况。对35例晚期HIV感染患者（疾病控制与预防中心，亚特兰大，IC或C期）的骨髓标本进行了形态学和培养检查（需氧菌、厌氧菌、真菌和分枝杆菌）。9例患者因血细胞减少接受了骨髓标本检查（9次穿刺和3次活检）；只有2例检查针对可能的病因：第一例患者为细小病毒B19感染，第二例患者为噬血细胞综合征。25例患者因不明原因发热接受了骨髓标本检查（23次穿刺和10次活检），仅1例确诊为结核分枝杆菌感染。另1例患者因淋巴瘤分期接受检查，穿刺和活检结果均正常。高比例患者存在嗜酸性粒细胞增多、浆细胞增多、铁储备增加、纤维化以及与骨髓发育异常相符的改变。总之，根据我们的经验，骨髓标本检查对明确晚期HIV感染患者血细胞减少和不明原因发热综合征的可能病因帮助不大。
