Haematological manifestations of childhood brucellosis

Abstract

Very few data on the frequency and diversity of haematological abnormalities occurring in brucellosis in children have been reported. In the present study 110 children (56 boys and 54 girls; age range, 2 months to 14 years) with proven brucellosis were investigated to determine the haematological changes during the active course of this infection. Anaemia was detected in 48 (44%) patients, of whom four had evidence of haemolysis. Leukopenia occurred in 33% of the cases, with neutropenia and/or lymphopenia being the most striking features encountered. Thrombocytopenia was found in six (5%) patients and pancytopenia in 15 (14%) patients, of whom one developed disseminated intravascular coagulation. Clinically detectable bleeding occurred in five (4.5%) patients whose platelet counts were significantly low. Hypersplenism, haemophagocytosis and granulomatous lesions of the bone marrow appear to play a fundamental role in producing these abnormalities of the peripheral blood. Brucellosis may be considered in patients whose blood picture reveals haemolytic anaemia, leukopenia, thrombocytopenia or pancytopenia, particularly when the disease is epidemiologically suspected.

A Case of HIV Infection with Thrombocytopenia: Assosiation of HIV, Thrombotic Thrombocytopenic Purpura and Brucellosis

“…The incidence of pancytopenia in patients with brucellosis is between 3 and 21%. However microangiopathic hemolytic anemias associated with brucellosis have rarely been reported [8][9][10][11].…”

A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis

“…We have previously reported inter- esting cases of brucellosis in patients presenting with either initial hematological manifestations or unexplained fever that were referred to our university hospitals' hematologyoncology clinics [11][12][13][14][15][16]. Several data have been reported on the frequency and diversity of hematological abnormalities occurring in brucellosis [6,7,17]. In the published series, the incidence of pancytopenia with brucellosis varies from 3 to 21% [5,17,18].…”

“…The disease also produces a variety of nonspecific hematological abnormalities. Bone marrow and the spleen are commonly involved, and such involvement may result in a hypoplastic pattern on the peripheral blood smear [5,6]. Hematological complications of mild anemia and leukopenia have been frequently associated with acute brucellosis, but pancytopenia and thrombocytopenia are less frequently encountered [7,8].…”

Hematological Profiles During Acute and Subacute Brucellosis in Sprague-Dawley Rats Experimentally Infected with B. abortus biotype 1

“…The disease also produces a variety of nonspecific hematological abnormalities. Bonemarrow and the spleen are commonly involved and such involvement may result in a hypoplastic pattern in the peripheral blood smear [10] . Reproductive failure, infertility and abortion are the main clinical manifestations of brucellosis in domesticated animals.…”

“…These changes of hematological parameters are the clear indication of anemia in the infected SD rats. In case of human anemia was detected in 48 (44%) patients with proven brucellosis [10] . Crosby et al [25] studied hematologic abnormalities in 38 patients with brucellosis.…”