       Document 0183
 DOCN  M9460183
 TI    Thrombotic microangiopathy and retroviral infections: a 13-year
       experience.
 DT    9408
 AU    Ucar A; Fernandez HF; Byrnes JJ; Lian EC; Harrington WJ Jr; Department
       of Medicine, University of Miami, School of Medicine,; FL 33136.
 SO    Am J Hematol. 1994 Apr;45(4):304-9. Unique Identifier : AIDSLINE
       MED/94234121
 AB    Eleven of fifty serum samples collected from patients with a diagnosis
       of thrombotic microangiopathy (TMA), from 1979 to 1991, tested positive
       for antiretroviral antibodies. Seven had human immunodeficiency virus
       (HIV) infection, and four had human lymphotrophic virus, type I (HTLV-I)
       infection. All patients were treated with plasma exchange and/or
       infusion, but only two of the HIV-infected patients obtained a complete
       response (CR) and one of them died after a few months. Combined results
       from the literature indicate that most patients with HIV infection
       survive less than one year from the initial diagnosis of TMA. In the
       setting of HIV infection, TMA is a treatable condition, but survival for
       most patients is less than 12 months. Three of the four HTLV-I infected
       patients with TMA had a CR. These observations strongly suggest that
       both HIV and HTLV-I infections are associated with TMA, but rigorous
       epidemiologic studies will be needed to determine the relative risk for
       each. Retroviral infections should be considered in patients with TMA,
       especially if the patient has associated risk factors and demographic
       characteristics.
 DE    Adult  AIDS-Related Opportunistic Infections/BLOOD/EPIDEMIOLOGY  Case
       Report  DNA, Viral/ANALYSIS/GENETICS  Female  Hemolytic-Uremic
       Syndrome/BLOOD/*COMPLICATIONS/EPIDEMIOLOGY  Human
       HIV/GENETICS/IMMUNOLOGY  HIV Antibodies/ANALYSIS/IMMUNOLOGY  HIV
       Infections/BLOOD/COMPLICATIONS/EPIDEMIOLOGY  HTLV
       Antibodies/ANALYSIS/IMMUNOLOGY  HTLV-I/GENETICS/IMMUNOLOGY  HTLV-I
       Infections/BLOOD/COMPLICATIONS/EPIDEMIOLOGY  Male  Middle Age
       Polymerase Chain Reaction  Purpura, Thrombotic
       Thrombocytopenic/BLOOD/*COMPLICATIONS/  EPIDEMIOLOGY  Retroviridae
       Infections/BLOOD/*COMPLICATIONS/EPIDEMIOLOGY  Risk Factors  Survival
       Analysis  Time Factors  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

