Hematologic Sequelae Viral illness:Coagulation abnormalities

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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HEMATOLOGICAL MANIFESTATIONS OF SYSTEMIC ILLNESS

Hematological Manifestation of Systemic illness

Related Topics

Systemic and Chronic Illnesses and Infections

Bone Marrow Infiltration

Dr. Bharat R. Agarwal
Pediatric Hematologist-Oncologist, Division of Pediatric Hem-Onco,
B.J. Wadia Hospital for Children

Continued...

Viral Illnesses with Marked Hematologic Sequelae :

Coagulation abnormalities :

The following abnormalities occur :
- Dysregulation of immunoglobulin production may affect the coagulation cascade.
- The dysregulation of immunoglobulin production may also occasionally result in beneficial effects, as in the resolution of anti-factor VIII antibodies in HIV-infected hemophiliacs.
- Lupus-like anticoagulant (antiphospholipid antibodies) or anticardiolipin antibodies occur in 82% of patients. This is not associated with thrombosis in AIDS patients. Thrombosis may occur secondary to protein S deficiency. Low levels of protein S occur in 73% of patients.
Role of hematopoietic growth factors in Acquired Immunodeficiency Syndrome

Erythropoietin : Recombinant human erythropoietin (rHuEPO) results in a significant improvement in hematocrit and reduces transfusion requirements while the patient is receiving zidovudine. RHuEPO therapy should be initiated if the erythropoietin threshold is less than 500 IU/l.

Neutrophil Growth Factors : Granulocyte colony-stimulating factor (G-CSF) in a dose of 5 mg/kg/day. SC is the most widely used growth factor in neutropenia.

Granulocytic-macrophage colony-stimulating factor (GM-CSF) improves neutrophil counts in drug-induced neutropenia. The effects of GM-CSF are seen within 24-48 hours with relatively low doses of (GM-CSF (0.1 ug/kg/day).

Interleukin-3 (IL-3) given in doses of 0.5-5 mg/kg/day increases neutrophil counts.
Cancers in Children with human immunodeficiency virus infection: Malignancies in children with HIV infection are not as common as those in adults. Following tables show the malignancies occurring in adults and in children with HIV infection in the order of frequency.

Table : AIDS-Related Neoplasms in Adults

Kaposi's Sarcoma
Non-Hodgkin's lymphoma
Anogenital cancers

cancer

Hodgkin's disease
Leiomyosarcoma
Testicular tumors
Conjunctival tumors
Melanoma
Renal tumors
Skin cancer

Lung cancer

Adenocarcinoma

Next : Viral Illnesses with Marked Hematologic Sequelae(Contd.)

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