Myelodysplasia in a Patient with Pulmonary Tuberculosis and HIV Infection (Clinical Case)

Abstract

Currently, there is still interest in the state of hematopoiesis in mixed infections due to a number of reasons. Specialists know the basic hematological characteristics of the infectious process. But it should be noted that despite the abundance of scientific information on this problem, there are relatively few clinical descriptions of hematological disorders during tuberculosis + HIV coinfection. Therefore, we consider the aim of the work to be to present a clinical observation of a patient with myelodysplasia with coinfection of tuberculosis + HIV. Materials and methods. At the first stage of the study, an analysis of clinical and laboratory data of a patient with tuberculosis + HIV co-infection was carried out. At the second stage of the study, a bibliographic search was carried out with a search depth of 10 years (2013–2023) using the CyberLeninka scientific electronic library and the PubMed search engine for biomedical research. As a result, only 7 publications on this issue were found. Results. A clinical case of a patient with disseminated pulmonary tuberculosis, MBT (–) and HIV infection is presented. Due to suspicion of multiple myeloma, a bone marrow examination was performed. Bone marrow preparations are cellular; megakaryocytes are found, varying in size and with different nuclear lobularity. Signs of myelodysplasia are expressed: uneven maturation of the nucleus and cytoplasm of granulocytes, hypogranularity, hypersegmentation and gigantic size of neutrophils, megaloblas toidity of erythroid cells and cytoplasmic bridges between normoblasts. No cytogenetic abnormalities characteristic of myelodysplastic syndrome were found. Thus, the patient was diagnosed with hematopoietic dysplasia, the clonality of which has not been proven. Conclusion. The myelodysplastic process during infections is not an exceptional phenomenon. But in this case, we showed three-line myelodysplasia in mixed infection. The authors of this observation will continue to monitor the patient’s situation in order to clarify the dynamics of myelodysplastic hematopoiesis and its possible transformation.

Acknowledgments
The authors are grateful to the Larisa G. Polushina, Cand. Sci. (Med.), Senior Researcher of the Central Research Laboratory of the Ural State Medical University (CSR USMU), and Maksim A. Kopenkin, Postgraduate Student of the CSR USMU, for their help in microphotography and design of the article.

For citation
Bazarnyi VV, Rodygina EV, Ivoilova MI. Myelodysplasia in a patient with pulmonary tuberculosis and HIV infection (Clinical case). Bulletin of USMU. 2024;(1):7–16. (In Russ.). EDN: https://elibrary.ru/FEWRIH.