A case report of isolated thrombocytopenia induced by brucellosis

Rad, Zahra Abbaspour; Sajedi, Behnam; Akbarieh, Samira; Heydari, Amir Hossein; Ali, Sahar Baba; Mojdehi, Amirhossein Moghtader

doi:10.12980/apjtd.7.2017d6-406

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…Our results are consistent with the above-mentioned studies. 6 , 10 The combination of doxycycline and rifampicin remain appropriate to treat Brucella -induced thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

“…There have been few reports of Brucella-induced thrombocytopenia, most of which were case reports. [3][4][5][6][7] The precise pathological characteristics of this process are unclear. However, there are some possible mechanisms, including bone marrow suppression, hypersplenism, hemophagocytosis, disseminated intravascular coagulation, and immune destruction of platelets.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] If an immunological mechanism is the main reason for thrombocytopenia, patients have a better prognosis following intravenous gamma globulin and steroids in conjunction with brucellosis treatment. 4,6,7 Brucellainduced thrombocytopenia that results from other different mechanisms should have corresponding treatment. Some reports have shown that antibiotics alone can cure thrombocytopenia due to Brucella.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] There have been few reports of Brucella-induced thrombocytopenia, most of which were case reports. [3][4][5][6][7] This study aimed to describe 16 cases of thrombocytopenia due to Brucella and to present a relevant literature review.…”

Section: Introductionmentioning

confidence: 99%

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Brucella-induced thrombocytopenia: a retrospective study of 16 patients

et al. 2019

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Objective We aimed to describe the clinical characteristics and treatment outcomes of 16 patients with Brucella-induced thrombocytopenia. Methods We assessed 16 patients with Brucella-induced thrombocytopenia between 2012 and 2016 in The First Affiliated Hospital of Xinjiang Medical University. The diagnosis of Brucella-induced thrombocytopenia was ≤100,000 platelets/mm3. Results All patients were men. The most common symptoms of patients were fever (100%), sweating (81.2%), fatigue (75%), and joint pain (25%). The most common signs of physical examinations were an enlarged liver (75%) and enlarged spleen (50%). The lowest thrombocyte count was 2000/mm³ and the highest count was 72,000/mm³. An agglutination test antibody was positive (≥1:160) in 12 (75%) patients with the highest antibody titer of 1:800. Brucella melitensis was isolated from blood cultures in nine (56.3%) patients. All patients were administered antimicrobial agents. The patients’ platelet counts were normal at a follow-up of 12 months. Conclusion Classical brucellosis therapy is adequate for patients with a platelet count > 20,000/mm3. The five-drug regimen of doxycycline + rifampin + platelet transfusions + corticosteroids + intravenous immunoglobulin is recommended for patients when the platelet count is < 10,000/mm3. These findings have important implications for improving treatment outcome in patients with Brucella-induced thrombocytopenia.

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“…Our results are consistent with the above-mentioned studies. 6 , 10 The combination of doxycycline and rifampicin remain appropriate to treat Brucella -induced thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Brucella-induced thrombocytopenia: a retrospective study of 16 patients

et al. 2019

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“…Decreasing the expression of miR-21 can protect myocytes in the myocarditis process. 9,10 Tocilizumab (TCZ) is recently approved to be used for critically ill hospitalized COVID-19 patients. TCZ is a monoclonal antibody that antagonizes the interleukine-6 (IL-6) receptor.…”

Section: Introductionmentioning

confidence: 99%

MiR-21 and Tocilizumab interactions improve COVID-19 myocarditis outcomes

Heydari

Ghaffari²,

Khani³

et al. 2023

Therapeutic Advances in Cardiovascular Disease

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Background: Myocarditis is now one of the most fatal and morbid complications of COVID-19. Many scientists have recently concentrated on this problem. Objectives: This study assessed the effects of Remdesivir (RMS) and Tocilizumab (TCZ) in COVID-19 myocarditis. Design: Observational, cohort study. Methods: Patients with COVID-19 myocarditis were enrolled in the study and divided into three groups, TCZ-treated, RMS-treated, and Dexamethasone-treated patients. After 7 days of treatment, patients were reassessed for improvement. Results: TCZ significantly improved patients’ ejection fraction in 7 days, but it had limited efficacy. RMS improved inflammatory characteristics of the disease, but RMS-treated patients showed exacerbated cardiac function over 7 days, and the mortality rate with RMS was higher than TCZ. TCZ protects the heart by decreasing the miR-21 expression rate. Conclusion: Using Tocilizumab in early diagnosed COVID-19 myocarditis patients can save their cardiac function after hospitalization and decrease the mortality rate. miR-21 level determines the outcome and responsiveness of COVID-19 myocarditis to treatment.

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