Seroprevalence of human immunodeficiency virus infection in an infectious disease hospital.

AIMS AND OBJECTIVES: To analyse clinicopathological features of HIV infected patients admitted in an infectious disease hospital in Mumbai. MATERIAL AND METHODS: Retrospective study of 501 patients admitted from 1st September, 1996 to 28th February, 1998 and screened for HIV status out of clinical suspicion was carried out. HIV seropositivity was established by double confirmation of spot test results with microwell Elisa test. RESULTS: HIV seropositivity was seen in 39.92%. Out of these 94% were adults with male preponderance and 96.5% had only HIV-1 infection. The significant clinical features in HIV positive patients were chronic diarrhea (51.5%), prolonged fever (41.5%) and history of exposure (34%). Pulmonary tuberculosis could be diagnosed in 19.5% of HIV positive patients. In patients with prolonged/recurrent jaundice HBsAg and HIV was noted as a coinfection within 10/42 cases tested. CONCLUSIONS: Increasing prevalence of HIV seropositivity was noted in patients admitted to an infectious disease hospital. Association of HIV infection with tuberculosis and in icteric cases with HBsAg was significant. The HIV screening should be carried out in patients with prolonged illness resistant to usual mode of treatment.

Dyshormonogenetic goitre with clear cell change resembling parathyroid adenoma--a case report.

Dyshormonogenesis is a rare cause of goitre. It is manifestation of mutation in genes controlling the proteins involved in synthesis of thyroid hormones. Though there is wide spectrum of biochemical and clinical presentation, pathological features are similar in all defects. Nonencapsulated nodules with minimal regressive changes and lack of lymphocytic infiltration are important diagnostic features. Clear cell change as seen in this case is common and needs to be differentiated from parathyroid adenoma. Hypercellularity with cellular atypia should not lead to misdiagnosis of malignancy.

Peliosis of spleen presenting as splenic rupture with haemoperitoneum--a case report.

Peliosis of spleen is usually associated with peliosis of liver. Oval to round markedly dilated blood filled cystic spaces predominantly in parafollicular area is the characteristic feature of peliosis to differentiate it from congested sinuses. Exposure to viruses chemicals, contraceptive steroids or chronic debilitating disorders including malignancies are the various possible etiological factors. Though peliosis may remain asymptomatic, fatal intraperitoneal haemorrhage may occur due to its rupture. We report a case of peliosis of spleen presenting as splenic rupture with haemoperitoneum.

Immunohistochemistry of thyroid carcinoma--an experience with thyroglobulin and calcitonin.

A retrospective immunohistochemical study of 33 cases of primary thyroid carcinomas and 5 cases of metastases to thyroid was carried out. The immunostaining for thyroglobulin and calcitonin was done by peroxidase-anti-peroxidase (PAP) technique. The optimum staining results were obtained by proper standardisation of the staining procedure and reagents. The sections were systematically evaluated for immunostaining intensity and distribution. The observations revealed that thyroglobulin and calcitonin could be useful as sensitive and specific histogenetic markers for follicular and parafollicular cell derived thyroid carcinomas respectively. However, there was no absolute correlation between thyroglobulin positivity and grade of differentiation. The immunostaining could not differentiate follicular adenoma from follicular carcinoma. More extensive study using other markers may be useful for better patient management.