Document 0776
 DOCN  M9460776
 TI    [Thrombocytopenia associated with human immunodeficiency virus
       infection. Immunologic study of 60 patients addicted to parenteral
       drugs]
 DT    9404
 AU    Muniz-Diaz E; Domingo P; Lopez M; Pujol-Moix N; Fuster M; Madoz P;
       Servicio de Hemoterapia y Hematologia, Hospital de la Santa Creu; i Sant
       Pau, Barcelona.
 SO    Med Clin (Barc). 1993 Dec 11;101(20):761-5. Unique Identifier : AIDSLINE
       MED/94158382
 AB    BACKGROUND: The immunologic study of 60 intravenous drug addict patients
       who were seropositive for the human immunodeficiency virus (HIV) and who
       developed thrombocytopenia (TP) is reported with the aim of establishing
       the relation of possible pathogenic factors which may trigger this
       complication. METHODS: In all the patients the presence of antiplatelet
       antibodies was studied by direct and indirect immunofluorescence
       together with crypto-antibodies, immune complexes, lymphocytotoxic
       antibodies, antiphospholipid antibodies, immunoglobulins, lymphocytic
       populations and subpopulations and serology against different infectious
       agents. RESULTS: Antiplatelet antibodies were detected in 71% of the
       patients of which 50% corresponded to immunoglobulins of IgG class, 12%
       to IgM, 21% to IgG plus IgM, 7% IgM plus IgA, 5% to IgG plus IgA and 5%
       IgG plus IgM plus IgA. In these patients a characteristic membrane
       fluorescence pattern was observed in which the fluorescein is
       distributed forming a thick, hard point. In 3 patients EDTA dependent
       crypto-antibodies were detected which in one case determined
       pseudothrombocytopenia. The immune complexes were demonstrated in 50% of
       the cases. Other findings were: hypergammaglobulinemia (86%), decrease
       in the CD4 population (47%), CD4/CD8 ratio < 1 (71%), lymphocytotoxic
       antibodies (70%), antiphospholipid antibodies (60%), and seropositivity
       for cytomegalovirus (62%), Epstein-Barr virus (10%) and hepatitis B
       virus (anti-HBc 75%, HBsAg 33%). CONCLUSIONS: Thrombocytopenia
       associated to infection by the human immunodeficiency virus in
       intravenous drug addict patients is due to the concurrence of multiple
       factors. The relevance of each may vary according to the risk practice
       of the collective analysed and even within the same group of some
       individuals or others. The numerous serologic findings in these patients
       fundamentally express the existence of a chronic polyclonal stimulation
       of B cells which may be initiated by the action of the drug itself and
       which becomes aggravated during the course of the multiple acquired
       infections among which that due to the human immunodeficiency virus is
       of note.
 DE    Adult  Autoantibodies/*BLOOD  Blood Platelets/IMMUNOLOGY  English
       Abstract  Female  Human  HIV Infections/BLOOD/*COMPLICATIONS
       Immunoglobulins/BLOOD  Male  Substance Abuse,
       Intravenous/BLOOD/*COMPLICATIONS  Thrombocytopenia/BLOOD/*IMMUNOLOGY
       JOURNAL ARTICLE

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