Splenectomy in patients with AIDS

Mathew, Anna; Raviglione, Mario; Niranjan, Usha; Sabatini, Maria T.; Distenfeld, Ariel

doi:10.1002/ajh.2830320305

Cited by 25 publications

(9 citation statements)

References 11 publications

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“…HIV-infected patients with secondary infections caused by different pathogens including mycobacteria, fungi, CMV, Toxoplasma gondii and Salmonella can present with splenomegaly [155–157], which may lead to an increase in peripheral destruction of granulocytes along with other blood cell types such as erythrocytes and platelets.…”

Section: Introductionmentioning

confidence: 99%

Neutropenia during HIV Infection: Adverse Consequences and Remedies

Shi¹,

Sims

Hanna³

et al. 2014

International Reviews of Immunology

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Neutropenia frequently occurs in patients with Human immunodeficiency virus (HIV) infection. Causes for neutropenia during HIV infection are multifactoral, including the viral toxicity to hematopoietic tissue, the use of myelotoxic agents for treatment, complication with secondary infections and malignancies, as well as the patient’s association with confounding factors which impair myelopoiesis. An increased prevalence and severity of neutropenia is commonly seen in advanced stages of HIV disease. Decline of neutrophil phagocytic defense in combination with the failure of adaptive immunity renders the host highly susceptible to developing fatal secondary infections. Neutropenia and myelosuppression also restrict the use of many antimicrobial agents for treatment of infections caused by HIV and opportunistic pathogens. In recent years, HIV infection has increasingly become a chronic disease because of progress in antiretroviral therapy (ART). Prevention and treatment of severe neutropenia becomes critical for improving the survival of HIV-infected patients.

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Section: Introductionmentioning

confidence: 99%

Neutropenia during HIV Infection: Adverse Consequences and Remedies

Shi¹,

Sims

Hanna³

et al. 2014

International Reviews of Immunology

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“…This anemia may be severe enough to cause extramedullary hematopoietic splenomegaly, a lesion that is sometimes diagnosed in HIV-infected humans with no other underlying disease process. 17,23 The three monkeys in this study did not have anemia or bone marrow alterations that would have resulted in EMH. Even if they had anemia, the spleen and liver would most commonly have been the first sites of EMH.…”

mentioning

confidence: 83%

Extramedullary Hematopoiesis in the Mandibular Lymph Node of Simian-Human Immunodeficiency Virus-Infected Rhesus Monkeys (Macaca mulatta): A Report of Three Cases

et al. 2004

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Abstract. Three cases of extramedullary hematopoiesis (EMH) in the mandibular lymph nodes of rhesus monkeys, experimentally infected intravenously with a chimeric simian human immunodeficiency virus, are described. On histopathologic evaluation, multiple sections of mandibular lymph node from all animals showed evidence of EMH, which included erythroid, myeloid, or megakaryocytic precursor cells (or all) within the medullary sinuses. Immunohistochemistry was used for positive identification of multiple cell types. Evidence of EMH was not observed in numerous sections of axillary, inguinal, cervical, hilar, or mesenteric lymph nodes or in any other tissues examined. To our knowledge, this is the first report on EMH within the lymph nodes of rhesus monkeys without an obvious underlying disease process or stringent blood-sampling schedule warranting the need for increased hematopoiesis outside the confines of the bone marrow.

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“…[61][62][63][64][65] Some patients may have portal hypertension from severe liver disease, portal vein fibrosis or thrombosis. 61 Patients with an enlarged spleen commonly have left upper quadrant pain, and the spleen is tender to palpation.…”

Section: Splenomegalymentioning

confidence: 99%

The Surgeon and AIDS

Saltzman

Williams²,

Gelfand³

et al. 2005

Arch Surg

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Background: Since the first reports on indications and outcome for abdominal procedures in the HIV/AIDS patient were published 20 years ago, the epidemiology and presentation of surgical illness have changed remarkably with the advent of new antiviral regimens. A review of the now occasional, but still important, role of the surgeon in contemporary treatment of HIV/AIDS is presented.Data Sources: Information was obtained by PubMed searches of medical journals, examination of reference lists, and Web resources.Study Selection: Articles on operative indications, outcomes, precautions, source of transmission, and pathophysiology of HIV/AIDS were selected.Data Extraction: Data was obtained from peerreviewed articles and references. Data Synthesis:The last 2 decades have seen a decrease in operative mortality from as high as 85% to approximately 15% with a corresponding improvement in morbidity. Surgical emergencies such as appendicitis occur in HIV patients with the same frequency as non-HIV patients and are treated with equivalent results. Concern about transmission of HIV in the operating room has lessened somewhat. Although still a hazard, the probability of HIV transmission with accidental exposure is low, with risks below 0.5% for percutaneous hollow-bore needles and less than 0.1% risk for mucus membrane exposure.Conclusions: Improved surgical outcomes together with of accurate data on the modes and likelihood of accidental transmission of HIV to members of the surgery team have resulted in the treatment of HIV/AIDS patients becoming an accepted part of routine surgical practice.

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Splenectomy in patients with AIDS

Cited by 25 publications

References 11 publications

Neutropenia during HIV Infection: Adverse Consequences and Remedies

Neutropenia during HIV Infection: Adverse Consequences and Remedies

Extramedullary Hematopoiesis in the Mandibular Lymph Node of Simian-Human Immunodeficiency Virus-Infected Rhesus Monkeys (Macaca mulatta): A Report of Three Cases

The Surgeon and AIDS

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