Document Detail


Schistocytosis and a thrombotic microangiopathy-like syndrome in hospitalized HIV-infected patients.
MedLine Citation:
PMID:  9929102     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Approximately 150 human immunodeficiency virus (HIV)-infected patients with a thrombotic microangiopathy (TMA)-like syndrome have been reported in the literature since the early 1980s. The prevalence of a TMA-like syndrome in our hospitalized patients was determined to discern whether it is a more common occurrence than previously recognized and, if possible, to delineate risk factors for its occurrence. A total of 350 patients admitted consecutively to the Johns Hopkins Hospital HIV inpatient service were assessed from May 1, 1996 through February 1, 1997. These patients were evaluated for the presence of anemia, thrombocytopenia, fragmented erythrocytes on peripheral blood smear (schistocytosis), renal dysfunction, neurologic dysfunction, and fever. The association of a TMA-like syndrome with demographic and clinical factors was analyzed. Schistocytosis was present in 24% of the patients and a TMA-like syndrome (anemia, thrombocytopenia, schistocytosis + renal dysfunction or neurologic dysfunction, and fever) was present in 7% of the patients. The patients who had a TMA-like syndrome were more likely to have a low CD4 lymphocyte count or CD4 percentage, Centers for Disease Control and Prevention stage C disease, and have bacterial sepsis. Age, race, HIV risk group, other diagnoses, and prescribed drugs were not associated. Patients were more likely to die if they had a TMA-like syndrome, independently of level of immunosuppression. Schistocytosis and a TMA-like syndrome are relatively common in hospitalized HIV-infected patients. This syndrome may contribute to mortality and morbidity, particularly in patients with more advanced disease.
Authors:
R D Moore
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of hematology     Volume:  60     ISSN:  0361-8609     ISO Abbreviation:  Am. J. Hematol.     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-02-11     Completed Date:  1999-02-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7610369     Medline TA:  Am J Hematol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  116-20     Citation Subset:  IM; X    
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. rmoore@welchlink.welch.jhu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Erythrocytes, Abnormal*
Female
HIV Infections / blood,  complications*
HIV Seropositivity
Hospitalization
Humans
Male
Middle Aged
Purpura, Thrombocytopenic / blood,  complications
Syndrome
Thrombosis / blood,  complications*
Grant Support
ID/Acronym/Agency:
FD-U-000977/FD/FDA HHS; R01 HS07809/HS/AHRQ HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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