Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2019; 40(04): 594
DOI: 10.4103/ijmpo.ijmpo_111_18
Letter to Editor

Malignancy‑Associated Microangiopathic Hemolytic Anemia and Thrombocytopenia

Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al‑Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
   Permissions and Reprints

Sir,

Abdulla et al. nicely described two Indian patients who presented with microangiopathic hemolytic anemia (MAHA) and thrombocytopenia due to disseminated malignancy (DM).[1] I presume that underlying human immunodeficiency virus (HIV) infection might contribute to the revelation of DM in the studied two patients. That contribution could be addressed in dual aspects. On the one hand, it is obvious that patients with HIV infection have increased tendency to have various neoplastic lesions compared to healthy individuals. The increased propensity of neoplasms among HIV-positive patients has been thought to be related to different factors, including coinfection with oncogenic viruses, immunosuppression, and life prolongation secondary to the use of antiretroviral therapy.[2] To the best of my knowledge, HIV infection is a significant health hazard in India. The available data pointed out 0.26% HIV seroprevalence compared with a global average of 0.2%.[3] On the other hand, thrombotic microangiopathy is associated with HIV infection [4] and it could be the first clinical manifestation of HIV infection.[5] I presume that implementing the diagnostic workup of viral overload and CD4 count estimations was solicited in the studied two patients. If that diagnostic workup was accomplished and it revealed underlying HIV infection, the two cases in question could be truly regarded novel case reports. This is because concurrent HIV infection and DM uncovered by MAHA and thrombocytopenia have never been reported in the literature so far.



Publication History

Received: 11 May 2018

Accepted: 21 June 2018

Article published online:
03 June 2021

© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Abdulla MC, Alungal J, Nair LK, Musambil M. Malignancy associated microangiopathic hemolytic anemia and thrombocytopenia. Indian J Med Paediatr Oncol 2018; 39: 254-6
    Article in Thieme ConnectGoogle Scholar
  • 2 Valencia Ortega ME. Malignancies and infection due to the human immunodeficiency virus. Are these emerging diseases? Rev Clin Esp 2018; 218: 149-55
    PubMedGoogle Scholar
  • 3 Paranjape RS, Challacombe SJ. HIV/AIDS in India: An overview of the Indian epidemic. Oral Dis 2016; 22 (01) Suppl 10-4
    CrossrefPubMedGoogle Scholar
  • 4 Gilardin L, Malak S, Schoindre Y, Galicier L, Veyradier A, Coppo P. Human immunodeficiency virus-associated thrombotic microangiopathies. Rev Med Interne 2012; 33: 259-64
    CrossrefPubMedGoogle Scholar
  • 5 Sarmiento M, Balcells ME, Ramirez P. Thrombotic microangiopathy as first manifestation of acute human immunodeficiency virus infection: A case report and review of the literature. J Med Case Rep 2016; 10: 152
    CrossrefPubMedGoogle Scholar