Brucellosis‐induced immune thrombocytopenia mimicking ITP: a report of seven cases

Abstract

Brucellosis continues to be an important cause of fever in underdeveloped countries and in rural areas of developed world. It is a multisystemic disease, associated with wide variety of symptoms. A wide variety of symptoms, including haematological abnormalities, such as anaemia, thrombocytopenia, pancytopenia, dissemine intravascular coagulation and leucopoenia could be seen, all of which are more common than usually thought. In this short study, we present a relatively uncommon haematological manifestation that of isolated thrombocytopenia mimicking idiopathic thrombocytopenic purpura, which we observed in seven of 114 patients who were diagnosed with brucellosis in our hospital over a 2-year period. Having given brucellosis treatment with rifampicin and doxycycline, complete remission was achieved and thrombocyte count returned to normal in all cases.

An uncommon presentation of Sjögren's syndrome and brucellosis

“…On the other hand, brucellosis is a multisystem disease with a broad spectrum of clinical manifestations; hematological abnormalities ranging from fulminant disseminated intravascular coagulation to anemia, leucopoenia, thrombocytopenia, and clotting disorders can occur [11,12]. Disseminated intravascular coagulation (DIC) is common in patients with bacterial septicemia; however, it is rare in patients with brucellosis [11,12].…”

“…Disseminated intravascular coagulation (DIC) is common in patients with bacterial septicemia; however, it is rare in patients with brucellosis [11,12]. Bacterial products such as endotoxin can cause endothelial damage or bind to platelets, causing them to aggregate and be removed from the circulation [13].…”

An Uncommon Case of Acute Brucellosis Presenting with Severe Thrombocytopenia

“…Brucella-associated thrombocytopenia can be associated with hypersplenism, autoimmune destruction due to the development of antithrombocyte antibodies, disseminated intravascular coagulopathy (DIC), hemophagocytosis and granulomas in bone marrow (6,9,11,13,14). Sevinc et al (12) presented the case of a patient who presented with thrombocytopenia of 9,000/mL and received a diagnosis of transient ITP.…”

“…Several authors have reported good responses to steroid treatment in patients with thrombocytopenia induced by Brucella spp. Plasma exchange, intravenous gamma globulin administration or antibacterial treatment only have also been used successfully in some patients (6,11,12,14,16). We found no brucellosis cases of steroid-refractory thrombocytopenia reported in the literature.…”

“…This disease can involve many systems, including the reticuloendothelial system, musculoskeletal system, gastrointestinal system, cardiovascular system, lymphoreticular system and central nervous system, and can therefore present with a wide variety of clinical pictures and complications. Brucella infection can show many hematological signs such as anemia, thrombocytopenia, leucopenia and pancytopenia (5,6).…”