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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
Author(s) -
VAN SCHALKWYK W. A.,
OPIE J.,
NOVITZKY N.
Publication year - 2011
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/j.1751-553x.2010.01280.x
Subject(s) - medicine , bone marrow , thrombocytopenic purpura , lymphoma , biopsy , bone marrow examination , retrospective cohort study , bone marrow aspirate , pathology , platelet
Summary Introduction: 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. Conclusion: In our study group, a bone marrow biopsy was a useful investigation with a high diagnostic yield.