Hematologic Manifestations of Brucellosis in Children

Abstract

Brucellosis is commonly presented with cytopenia, especially in bacteremic episodes with fever. However, pancytopenia is uncommon and its finding should alert the physician to look for other possible etiologies.

Clinical and Laboratory Characteristics of Childhood Brucellosis in High-Risk Area of Western China

“…However, Hb, ESR and Ferritin only changed in osteoarticular involvement group and there was no difference between group without osteoarticular involvement and control group. The ROC analysis revealed that NEU, CRP and ALT may have a complementary role in the differential diagnosis of childhood brucellosis.These abnormal laboratory findings were accordance with the results of other studies (29)(30)(31). Clinical and laboratory characteristics of pediatric brucellosis patients with osteoarticular involvement are differ from cases without skeletal complications.…”

Clinicoepidemiological findings of childhood brucellosis in a tertiary care center in Central Anatolia: with the emphasis of hematological findings

“…1 The incidence of anemia has been reported as 13.3%-55% in different pediatric series. 1,12,[18][19][20] In the present study anemia was the most common hemeatologic finding of brucellosis. We used hemoglobin levels determined for age to be able to make an objective evaluation when describing hematological findings like most other studies.…”

“…Authors thought that, this difference may be a result of choosing relatively low cut-off for hemoglobin levels of 10 mg/dl in order to minimize the anemia cases misrelated to brucellosis. 18 Moderate to severe leukopenia and thrombocytopenia as well as normal leukocyte and thrombocyte counts in patients with brucellosis were reported. 1,12,18,19,21 On the contrary of leukopenia predominance in previous reports, in a prospective case-control study including 100 brucellosis patients and 100 healthy individuals, the authors found that WBC, CRP and neutrophil counts were significantly higher in the brucellosis group.…”

“…22 Pancytopenia and severe thrombocytopenia or isolated thrombocytopenia resulting in bleeding has rarely been reported in the course of brucellosis. 18,21,23 The pathogenesis of thrombocytopenia during brucellosis may be multifactorial such as; increased platelet clearance due to splenomegaly, the suppressive effect of brucellosis bacteremia on bone marrow, hemophagocytosis, and peripheral autoimmune destruction. 1,18,23 In a study that included five patients (2.6% of all) with isolated thrombocytopenia during the course of acute brucellosis, an examination of bone marrow aspirate had revealed increment of megakaryocytes in two of these patients that may also be seen in idiopathic thrombocytopenic purpura.…”

Treatment of Severe Refractory Thrombocytopenia in Brucellosis With Eltrombopag

“…Brucellosis also produces a variety of hematologic complications abnormalities in hematological parameters, including mild anemia, leukopenia, thrombocytopenia, or pancytopenia, which can be confused with hematological disease [16]. Mild anemia and leukopenia are frequent in brucellosis, whereas severe thrombocytopenia and pancytopenia are less frequently observed [17]. Therefore, brucellosis is frequently misdiagnosed as a primary hematologic disease or malignancy.…”