Heme Complications of non-heme diseases Flashcards
What are 3 AIDS defining illnesses?
- karposi sarcoma
- non hodgkins lymphoma
- cervical cancer
What is mechanism of increased heme abnormalities in HIV?
- suppression of hematopoiesis by cytokines
- direct HIV infection of bone marrow cells
- dysregulation of host immune system –> production of abnormal antibodies
What is the most common malignancy associated with HIV?
kaposi’s sarcoma
What is kaposi’s sarcoma?
tumor of endothelial cells involving skin, mucous membrane, lymph nodes, and visceral organs [lungs, GI]
red-purple to dark brown lesions
associated with HHV8
What is mech of non-hodgkins lymphoma in HIV?
lack of immunologic response to transformed cell, EBV driven lymphoproliferation
What is pathology of non-hodgkins lymphoma?
B cell lymphoma;diffuse large cells; high grade
What is etiology of non-hodgkins lymphoma?
EBV DNA seen in majority
What virus associated with primary CNS lymphoma in HIV?
EBV
What is mechanism of anemia in HIV?
- anemia of chronic inflammation
- myelophthisis [infiltration by opportunistic organisms]
- drug induced from anti-retrovirals
- direct suppression by parvovirus
- decrease B12
- immune mediated hemolysis
- blood loss
What is action of trimethroprim on heme?
inhibits dihydrofolate reductase and causes megaloblastic anemia
What kind of anemia normally associated with HIV?
normochromic normocytic anemia
What is normal retic count in HIV associated anemia?
usually inappropriately low; suggests erythropoiesis
What will bone marrow in HIV show?
- dysplastic changes in all cell lines
- giant proerythroblasts in parvovirus
- megaloblastic changes from drugs
- myelophthisis w/ tumor
Is thrombocytopenia in HIV a prognostic indicator for development of AIDS?
nope!
What are two treatments of HIV associated thrombocytopenia?
- zidovudine
- dideoxycytidine [DDI]
