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Haematological abnormalities in the acquired immunodeficiency syndrome.

Full haematological data were available on 22 of the first 30 patients with proven acquired immunodeficiency syndrome (AIDS) admitted to Johannesburg Hospital before July 1987. Reversal of the helper/suppressor T-cell ratio was present in all cases and polyclonal hypergammaglobulinaemia in 85% of cases. Sixty-eight per cent of patients were anaemic, 55% leucopenic, 77% lymphopenic and 23% thrombocytopenic. Four patients (out of 12 tested) exhibited a positive Coombs test (25%) and 2 patients (out of 13 tested) had a circulating lupus anticoagulant (15%). Bone marrow examination revealed all patients to be either normo- or hypercellular. Three patients exhibited haemophagocytosis. Given the increasing incidence of AIDS and the frequency of haematological abnormalities in this condition, the practising clinician should have a high index of suspicion when confronted by any unexplained haematological abnormality.