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Tytuł pozycji:

Hemophagocytic syndrome in patients living with HIV: a retrospective study.

Tytuł :
Hemophagocytic syndrome in patients living with HIV: a retrospective study.
Autorzy :
Telles JP; Instituto de Infectologia Emílio Ribas, Av. Dr Arnaldo, 165, São Paulo, SP, 01246-900, Brazil. .
de Andrade Perez M; Universidade Nove de Julho, São Paulo, SP, Brazil.
Marcusso R; Instituto de Infectologia Emílio Ribas, Av. Dr Arnaldo, 165, São Paulo, SP, 01246-900, Brazil.
Correa K; Instituto de Infectologia Emílio Ribas, Av. Dr Arnaldo, 165, São Paulo, SP, 01246-900, Brazil.
Teixeira RFA; Instituto de Infectologia Emílio Ribas, Av. Dr Arnaldo, 165, São Paulo, SP, 01246-900, Brazil.
Tobias WM; Division of Hemathology in Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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Źródło :
Annals of hematology [Ann Hematol] 2019 Jan; Vol. 98 (1), pp. 67-72. Date of Electronic Publication: 2018 Sep 25.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Publication: Berlin : Springer Verlag
Original Publication: Berlin ; New York : Springer International, c1991-
MeSH Terms :
Acquired Immunodeficiency Syndrome*/epidemiology
Acquired Immunodeficiency Syndrome*/microbiology
Acquired Immunodeficiency Syndrome*/pathology
Acquired Immunodeficiency Syndrome*/virology
Lymphohistiocytosis, Hemophagocytic*/epidemiology
Lymphohistiocytosis, Hemophagocytic*/microbiology
Lymphohistiocytosis, Hemophagocytic*/pathology
Lymphohistiocytosis, Hemophagocytic*/virology
Adult ; Bone Marrow/metabolism ; Bone Marrow/microbiology ; Bone Marrow/pathology ; Bone Marrow/virology ; Cryptococcosis/epidemiology ; Cryptococcosis/microbiology ; Cryptococcosis/pathology ; Cryptococcosis/virology ; Cryptococcus neoformans ; Cytomegalovirus ; Cytomegalovirus Infections/epidemiology ; Cytomegalovirus Infections/microbiology ; Cytomegalovirus Infections/pathology ; Cytomegalovirus Infections/virology ; Female ; HIV-1 ; Humans ; Male ; Mycobacterium ; Mycobacterium Infections/epidemiology ; Mycobacterium Infections/microbiology ; Mycobacterium Infections/pathology ; Mycobacterium Infections/virology ; Retrospective Studies
Contributed Indexing :
Keywords: AIDS; Ferritin; HIV; Hemophagocytic syndrome
Entry Date(s) :
Date Created: 20180927 Date Completed: 20190123 Latest Revision: 20190123
Update Code :
20210210
DOI :
10.1007/s00277-018-3500-9
PMID :
30255313
Czasopismo naukowe
Various infectious diseases can hyper-stimulate the immune system, causing hemophagocytic syndrome (HPS). Little is known regarding the accuracy of diagnostic criteria and epidemiological triggering factors in the acquired immunodeficiency syndrome (AIDS) setting. We investigated the major infectious disease triggers of HPS in patients living with human immunodeficiency virus (HIV)/AIDS and determined the accuracy of bone marrow aspiration (BMA). The inclusion criteria were (i) confirmed HIV diagnosis, (ii) bone marrow aspiration, and (iii) a minimum of four HPS criteria. Patients were further classified into those with four presumed HPS criteria, or ≥ 5 confirmed criteria. The disease triggers, accuracy of bone marrow aspiration, and prognosis markers were examined. Presumed HPS was observed in 15/36 patients (41%), and confirmed HPS in 58% (n = 21). The major etiological triggers were infection with Mycobacterium (34%), Cytomegalovirus (14%), Cryptococcus neoformans (11%), and hematological or tumoral disease (11%). BMA demonstrated 93% specificity on screening diagnosis (odds ratio [OR] 12.7, 95% confidence interval [CI] 1.4-115.1, P = 0.01). Ferritin > 5000 ng/mL correlated with probability of death in univariate analysis (OR 6.00, 95% CI 1.33-27.05, P = 0.02). Ferritin performance as test of death probability presented area under the curve as 0.74 (95% CI 0.56-0.91, P = 0.016). However, neither cluster of differentiation for lymphocyte count nor HIV viral load correlated with patient deaths. Mycobacterium spp. and Cytomegalovirus were the main factors triggering HPS, followed by Cryptococcus neoformans, and hematological and tumoral diseases. High ferritin levels were associated with increased death probability. High specificity was noted with BMA.

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