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

Authors

  • W. A. VAN SCHALKWYK,

    1. Department of Haematology, Groote Schuur Hospital and National Health Laboratory Service, University of Cape Town, Cape Town, South Africa
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  • J. OPIE,

    1. Department of Haematology, Groote Schuur Hospital and National Health Laboratory Service, University of Cape Town, Cape Town, South Africa
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  • N. NOVITZKY

    1. Department of Haematology, Groote Schuur Hospital and National Health Laboratory Service, University of Cape Town, Cape Town, South Africa
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Willem A. van Schalkwyk, Division of Haematology, Department of Clinical and Laboratory Sciences and National Health Laboratory Service, University of Cape Town and Groote Schuur Hospital, Anzio Road, Observatory, 7925 Cape Town, South Africa. Tel.: 27 (21) 417-9340; Fax: 27 (21) 419-7502; E-mail: willem.vanschalkwyk@nhls.ac.za

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.

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