PEDIATRIC AIDS: ANATOMOPATHOLOGY OF AUTOPSY CASES

Abstract

Nine autopsies were performed between 1988-1992 in children with AIDS belonging to a pool of 150 HIV infected children. Symptoms began in all patients during the first year of life(range:0-10 months, X̄:3 months). Seven died before one year of age, and two when they were 3 years old(range:0-36 months, X̄:1,7 years). Source of infection was: blood transfusion in 3(2 mothers and 1 child), tatco in both parents in 1, drug adiction in parents in 4, durg adiction and promiscuity in 1.Autopsies were performed and processed routinely. 5/9 had hepatho-megaly;3/9 splenomegaly;2/9 cardiomegaly;and 1 child had intraventricular bleeding. Lymphoid depletion in nodes was observed in 5/9 while heperplasia in 1/9. Thymic involution was observed in 1/9 while 4/9 had lymphoid depletion in their thymuses. In 1/9 the thymus was normal. Hepatic steatosis was observed in 7/9 and non specific hepatitis in 6/9. Diffuse alveolar damage was recorded in 4/9, PHL/LIP in 2/9 and lung angiomatosis in 2/9. Acute myocarditis was found in 2/9 and myocardial infarction in 1/9. Sepsis by CMV was found in 3/9, and South American trypanosomiasis, histoplasmosis, congenital syphilis and Pneumocystis carinii, one case each. We did not see neoplastic diseases, probably becuase of the early age of death of our cases. No concurrent infections were recorded. Lymph node and lung angiomatosis were not associated with Kaposi's sarcoma. We have not found neither coronary nor peripheral arteriopathy, as it was reported by Joshi et al. Neither did we find focal segmental sclerosis on the kidneys. Opportunistic infections could not have been diagnosed on clinical grounds.