scholarly journals Yield of Bone Marrow Examination in Diagnosing the Source of Fever of Unknown Origin

2009 ◽  
Vol 169 (21) ◽  
pp. 2018 ◽  
Author(s):  
Arnaud Hot
Keyword(s):  
Bone Marrow ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Bone Marrow Examination

Utility of bone marrow examination for workup of fever of unknown origin in patients with HIV/AIDS

2015 ◽  
Vol 68 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Andrés E Quesada ◽  
Ashok Tholpady ◽  
Audrey Wanger ◽  
Andy N D Nguyen ◽  
Lei Chen
Keyword(s):  
Bone Marrow ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Hiv Aids

Diagnostic yield of bone marrow examination in fever of unknown origin

2003 ◽  
Vol 115 (7) ◽  
pp. 591-592 ◽  
Author(s):  
Shahid Ahmed ◽  
Anita K. Siddiqui ◽  
Bhoomi Mehrotra
Keyword(s):  
Bone Marrow ◽  
Fever Of Unknown Origin ◽  
Diagnostic Yield ◽  
Unknown Origin ◽  
Bone Marrow Examination

scholarly journals Bone marrow evaluation in patients with fever of unknown origin

1970 ◽  
Vol 2 (3) ◽  
pp. 231-240 ◽  
Author(s):  
A Jha ◽  
RC Adhikari ◽  
R Sarda
Keyword(s):  
Bone Marrow ◽  
Blood Vessels ◽  
Cell Lines ◽  
Fever Of Unknown Origin ◽  
Hematological Parameters ◽  
Connective Tissue Diseases ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Infectious Agents ◽  
Collagen Vascular Diseases

Bone marrow examination is commonly requested investigations in cases of fever of unknown origin, irrespective of alteration in hematological parameters. More than 200 etiologies are associated with fever of unknown origin, and they are broadly divided into infectious, neoplastic, collagen vascular diseases, miscellaneous and undiagnosed. Many of these conditions directly or indirectly affect bone marrow. Marrow may show changes in cellular components, interstitium or in the blood vessels depending on the underlying local or systemic conditions. The three main hematopoietic cell lines may show variable hyperplasia, hypoplasia or aplasia of one or more than one cell lines, and occasionally dyspoiesis. Interstitium may show fibrosis, gelatinous transformation, or infiltration by abnormal cells. Amyloid deposits may be seen around blood vessels. Marrow may also show granulomas, infectious agents or neoplastic cells. Various reactive changes can be seen in the bone marrow in neoplastic, infectious and in connective tissue diseases. Infectious agents can be cultured from the marrow aspirate or can be demonstrated in marrow. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6029 JPN 2012; 2(3): 231-240

The Certainty of a Post-Bone Marrow Diagnosis: A Study of the Yield of Bone Marrow Biopsies in a Community Hospital Setting

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 34-35
Author(s):  
Manasi M. Godbole ◽  
Peter A. Kouides
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Fever Of Unknown Origin ◽  
Conflicts Of Interest ◽  
Diagnostic Yield ◽  
Hospital Setting ◽  
Unknown Origin ◽  
Nutritional Deficiencies ◽  
Bone Marrow Biopsies

Introduction: Most studies on the diagnostic yield of bone marrow biopsy including the one by Hot et al. have focused on the yield of bone marrow biopsies in diagnosing the source of fever of unknown origin. However, there have not been any studies performed to our knowledge looking at overall practice patterns and yield of bone marrow biopsies for diagnoses other than fever of unknown origin. We aim to determine the most common indications for performing bone marrow biopsies in a community-based teaching hospital as well as the yield of the biopsies in patients with specified and unspecified pre-test indications to estimate the rate of uncertain post-test diagnoses. Methods: We performed a retrospective data collection study at Rochester General Hospital, NY. A comprehensive search was conducted in our electronic medical data to identify all patients who underwent bone marrow biopsies over a 5 year period from January 2011 - December 2016 for indications other than fever of unknown origin. Patient data including demographics, pre-bone marrow biopsy diagnosis and post-bone marrow diagnosis was obtained. All patients above the age of 18 who underwent bone marrow biopsy for indications other than fever of unknown origin or follow up treatment of a hematological malignancy were included. Results: A total of 223 biopsies were performed. The median age was 59 years (age range- 23-95). One hundred and sixteen patients were male and 107 were female. The most common indications for performing bone marrow biopsy were evaluation of the following possible conditions: multiple myeloma (n=54), myelodysplastic syndrome [MDS] (n=47), lymphoma (n=28) and leukemia (n=18) as well as non-specific indications such as pancytopenia (n=40), anemia (n=22) and thrombocytopenia (n=11). The proportion of cases confirmed by bone marrow biopsy was 45/54 (83%) with the pre-marrow diagnosis of multiple myeloma, 34/47 cases (72%) with the pre-marrow diagnosis of MDS, 15/18 (83%) with the pre-marrow diagnosis of leukemia and 13/28 (46%) in those with the pre-marrow diagnosis of rule out lymphoma. Thirteen cases (18%) with possible MDS had post-bone marrow diagnoses of leukemia, anemia of chronic disease, myelofibrosis or medication-related changes. Five out of twenty two cases (23%) for anemia and 3/11 cases (27%) for thrombocytopenia without otherwise specified pre-bone marrow etiology had uncertain diagnosis after bone marrow biopsy. Conclusion: In about a fifth of patients necessitating a bone marrow, the diagnosis is discordant and can be surprising. It is also worth reporting that in these discordant results, non-hematological causes such as medications, anemia due to chronic diseases or conditions such as cirrhosis or splenomegaly from other etiologies were among the final diagnoses. Interestingly, 20% of the patients with unspecified pre-bone marrow diagnoses such as anemia or thrombocytopenia in our study had an unclear post-bone marrow diagnosis despite undergoing bone marrow biopsy. Our findings are a reminder that the bone marrow exam does not always lead to a definitive diagnosis and the need by exclusion to include in the differential non-hematological etiologies such as nutritional deficiencies, chronic kidney disease or autoimmune disorders. Disclosures No relevant conflicts of interest to declare.

scholarly journals Localized lymphadenopathy with myelodysplastic syndrome associated with tuberculosis

2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Aya Nakaya ◽  
Kazuyoshi Ishii ◽  
Toshiki Shimizu ◽  
Takeshi Tamaki ◽  
Yoshihisa Ishiura ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Myelodysplastic Syndrome ◽  
Valve Replacement ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Replacement Surgery ◽  
Laboratory Examinations ◽  
Valve Replacement Surgery

We report the case of a man who developed myelodysplastic syndrome (MDS) and refractory cytopenia of unilineage dysplasia, 5 months after aortic valve replacement surgery. He also developed fever of unknown origin. After bone marrow- and other laboratory examinations, he was diagnosed with tuberculosis.

Tobramycin versus Gentamicin, in Combination with Cephalotin and Carbenecillin, in Patients Undergoing Bone Marrow Transplantation

1981 ◽  
Vol 67 (6) ◽  
pp. 525-532 ◽  
Author(s):  
Andrea Bacigalupo ◽  
Maria T. Van Lint ◽  
Carla Volta ◽  
Grazia Grazi ◽  
Ornella Soro ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Renal Failure ◽  
Bone Marrow Transplantation ◽  
Acute Leukemia ◽  
Marrow Transplantation ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Febrile Episodes ◽  
Oral Decontamination ◽  
To Receive

Thirty-six patients with severe aplastic anemia or acute leukemia undergoing bone marrow transplantation or intensive hematologic treatments were randomized to receive gentamicin (1 mg/kg/iv q8h) or tobramycin (1 mg/kg/iv q8h) in combination with carbenecillin (500 mg/kg/day i.v. in 4 doses) and cephalotin (200 mg/kg/day i.v. in 6 doses), at the onset of fever during granulocytopenia. Patients in the gentamicin group were treated for a total of 541 patient days (minimum 5, maximum 106), and patients in the tobramycin group for 426 patient days (minimum 9, maximum 48). All patients received oral decontamination, which included the amino glycoside (either gentamicin or tobramycin) given intravenously. This study showed that 1) no patient had an increase in creatinine level above 1.3 mg % and no patient developed renal failure, 2) there was no difference between gentamicin and tobramycin in the efficacy of treating febrile episodes and/or major infections, 3) prolonged intravenous administration (up to 48 consecutive days in the tobramycin group and 106 consecutive days in the gentamicin group) was well tolerated and effective in treating fever of unknown origin in granulocytopenic patients: 45 of 72 febrile episodes resolved while the patients had a granulocyte count below 500/mm3.

Increased Bone Marrow Uptake of Ga-67 in Patients With Fever of Unknown Origin

1996 ◽  
Vol 21 (10) ◽  
pp. 786-791 ◽  
Author(s):  
LEO G. FLORES ◽  
SEISHI JINNOUCHI ◽  
SHIGEKI NAGAMACHI ◽  
TAKASHI OHNISHI ◽  
SHIGEMI FUTAMI ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Bone Marrow Uptake

scholarly journals A Clinico-Haematological Study of Causes of Pancytopenia

2021 ◽  
Vol 10 (40) ◽  
pp. 3533-3537
Author(s):  
Arvind Chouhan ◽  
Fuzail Ahmad ◽  
Manisha Jain
Keyword(s):  
Bone Marrow ◽  
Correct Diagnosis ◽  
Tertiary Care ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Cross Sectional ◽  
Smear Examination ◽  
Cellular Components ◽  
Haematological Study

BACKGROUND This is a clinic-haematological study, conducted in Sidhanta Hospital, Bhopal, to identify the causes of pancytopenia. Out of total 1200 cases of complete hemograms, 56 cases were categorized as pancytopenias, and out of these, 24 cases were subjected to bone marrow examination. The remaining 32 cases of pancytopenia, were put on periodic follow up with peripheral blood smear examination, based on clinical data. Pancytopenia is the simultaneous presence of anaemia, leucopenia and thrombocytopenia that may result from various disease processes, involving the bone marrow primarily or secondarily. Pancytopenia is reduction in all the three cellular components of the blood, namely red blood cells (RBCs), leucocytes (WBCs) and platelets. It is a common entity which is encountered by practitioners. The presentation is in the form of cytopenias leading to infections, anaemia, or bleeding manifestations. All the cases of pancytopenia need a through approach to reach to the cause of the same so that it can be managed in the best possible manner. Cytopenias are reduction in any of the three cellular components of the blood i.e. RBCs, WBCs or platelets. It can be reduction in two cellular components (bicytopenia) or a reduction in all the three cellular components (pancytopenia). In bicytopenia, the most common combination to be seen is anaemia and thrombocytopenia, whereas the least common is leucopenia with thrombocytopenia. (1) For practical purposes, it should have haemoglobin < 10 g%, absolute neutrophil count < 1,500/cumm and platelets < 1,00,000/cumm. It is labelled as severe when the three values are < 7 g%, < 500/cumm and < 20,000/cumm respectively. The purpose of this study was to find out different causes of pancytopenia and the use of bone marrow examination in evaluation of pancytopenia. METHODS This is a cross sectional study, conducted exclusively in the Department of Medicine, at a tertiary care hospital, in Bhopal from August 2019 to December 2019. A total of 56 cases of pancytopenia were analysed with clinico-haematological features. Criteria for diagnosis of pancytopenia were: Haemoglobin less than 10 gm/dl, TLC less than 4000/mm3 and platelet count less than 1,00,000/mm3. We have correlated the complete hemogram findings with bone marrow examination (if required) and peripheral smear examination in order to analyse the root cause of every case of pancytopenia. Pancytopenia is a haematological entity, we have to analyse the cause of it in order to find out the correct diagnosis and treat the patient accordingly. Bone marrow examination is useful in the investigation of PUO (pyrexia of unknown origin), as it leads to an etiological diagnosis in many of the cases. RESULTS In these 56 cases, only 24 cases (42.85 %) were subjected for bone marrow examination. Commonest cause of pancytopenia was episode of viral fever constituting 28 cases (50 %). CONCLUSIONS In cases of PUO, bone marrow examination is a very useful investigation. In cases diagnosed as idiopathic thrombocytopenic purpura (ITP), when the patient does not show improvement in counts, a repeat bone marrow examination should be done, as very rarely; acquired amegakaryocytic thrombocytopenia may be the cause. Though bone marrow examination is an absolute indication in cases of pancytopenia, it is important to wait for at least 2 – 3 weeks, and do a repeat hemogram, especially in cases of viral fever where the counts usually improve after fever subsides. KEY WORDS Pancytopenia, Bone Marrow, Viral Fever

Sign in / Sign up

Export Citation Format

Share Document