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HIV-induced thrombocytopenia
Epidemiology: 10% of HIV patients
Pathology:
1) immune thrombocytopenia
- platelet-directed antibodies & circulating immune complexes
2) HIV infection of megakaryocytes
Management:
1) anti-retroviral therapy if asymptomatic
- zidovudine 1000 mg/day
- promotes platelet production & inhibits platelet destruction
2) high-dose prednisone acutely if symptomatic, but avoid long-term
3) splenectomy
4) interferon-alpha, 3 million units SQ 3 times/week
5) high-dose intravenous immune globulin
General
HIV1/AIDS-associated hematologic disorder
thrombocytopenia
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- NEJM Knowledge+ Hematology