Hematological Complications in 787 Cases of Acute Brucellosis in Eastern Turkey

Aim: In this paper, we present the hematological findings of 787 cases diagnosed with acute brucellosis. Materials and Methods: Records of the cases seen between 1994 and 2006 were retrospectively investigated regarding hematological changes. Results: Three hundred sixty-five (46%) patients were male and 422 (54%) were female. Mean age was 32 (range: 11-78 years). Mean hematological values were as follows: Hb 12 g/dl (4-19), Htc 36% (12-56), leukocyte 6.9 x 109/L (0.5-25) and platelets 213 x 109/L (9-617). According to differential counts, 34% and 14% of patients had mononuclear cell and neutrophil dominance, respectively. Fifty-six percent of patients were found to have anemia, alone or in combination with leukopenia or thrombocytopenia. Fourteen percent of patients had thrombocytopenia, 12% leukopenia, 5% pancytopenia, 4% leukopenia + thrombocytopenia, 0.5% acute hemolysis, and 0.1% disseminated intravascular coagulation. Restoration of thrombocytopenia and leukopenia and improvement in clinical situation were seen within one week and recovery of anemia occurred within 3-4 weeks. Conclusions: Hematological complications such as anemia and leukopenia are more frequently seen in acute brucellosis cases. However, acute brucellosis should also be considered in the differential diagnosis in the presence of other hematological abnormalities such as severe thrombocytopenia, pancytopenia, acute hemolytic anemia, and disseminated intravascular coagulation.

Hematological Complications in 787 Cases of Acute Brucellosis in Eastern Turkey

Aim: In this paper, we present the hematological findings of 787 cases diagnosed with acute brucellosis. Materials and Methods: Records of the cases seen between 1994 and 2006 were retrospectively investigated regarding hematological changes. Results: Three hundred sixty-five (46%) patients were male and 422 (54%) were female. Mean age was 32 (range: 11-78 years). Mean hematological values were as follows: Hb 12 g/dl (4-19), Htc 36% (12-56), leukocyte 6.9 x 109/L (0.5-25) and platelets 213 x 109/L (9-617). According to differential counts, 34% and 14% of patients had mononuclear cell and neutrophil dominance, respectively. Fifty-six percent of patients were found to have anemia, alone or in combination with leukopenia or thrombocytopenia. Fourteen percent of patients had thrombocytopenia, 12% leukopenia, 5% pancytopenia, 4% leukopenia + thrombocytopenia, 0.5% acute hemolysis, and 0.1% disseminated intravascular coagulation. Restoration of thrombocytopenia and leukopenia and improvement in clinical situation were seen within one week and recovery of anemia occurred within 3-4 weeks. Conclusions: Hematological complications such as anemia and leukopenia are more frequently seen in acute brucellosis cases. However, acute brucellosis should also be considered in the differential diagnosis in the presence of other hematological abnormalities such as severe thrombocytopenia, pancytopenia, acute hemolytic anemia, and disseminated intravascular coagulation.

___

  • Sevinc A, Kutlu NO, Kuku I, Ozgen U, Aydogdu I, Soylu H. Severe epistaxis in brucellosis-induced isolated thrombocytopenia. Clin Lab Haematol 2000; 22: 373-5.
  • Singh M, Salaria M, Kumar L. Pneumonic presentation of brucellosis. Indian J Pediatr 2005; 72: 65-6.
  • Akıncı E, Bodur H, Erbay C, Cevik MA, Erbay A, Colpan A. A case of brucellosis presenting with severe thrombocytopenia. Turk J Haematol 2003; 20: 1-3.
  • Yalaz M, Arslan MT, Kurugol Z. Thrombocytopenic purpura as only manifestation of brucellosis in a child. Turk J Pediatr 2004; 46: 265-7.
  • Al-Eissa Y, Al-Nasser M. Hematological manifestation of childhood brucellosis. Infection 1993; 21: 29-32.
  • Al-Eissa YA, Assuhaimi SA, Al-Fawaz IM, Higgy KE, Al-Nasser MN, Al- Mobaireek KF. Pancytopenia in children with brucellosis: clinical manifestations and bone marrow findings. Acta Haematol 1993; 89: 132-6.
  • Sachdev A, Vohra R, Bijarnia S. Acute brucellosis of childhood: a case report with unusual features. Indian Pediatr 2001; 38: 1421-5.
  • Yildirmak Y, Palanduz A, Telhan L, Arapoğlu M, Kayaalp N. Bone marrow hypoplasia during Brucella infection. J Pediatr Hematol Oncol 2003; 25: 63-4.
  • Al-Shamahy HA, Wright SG. A study of 235 cases of human brucellosis in Sana’a, Republic of Yemen. East Mediterr Health J 2001; 7: 238- 46.
  • Aysha MH, Shayib MA. Pancytopenia and other hematological findings in brucellosis. Scand J Haematol 1986; 36: 335-8.
  • Moreno SM, Quiros JB, Casas CB. Pancytopenia due to hemophagocytosis in patients with brucellosis. A report of four cases. J Infect Dis 1983; 147: 445-9.
  • Kokoglu OF, Hosoglu S, Geyik MF, Ayaz C, Akalın S, Buyukbese MA et al. Clinical and laboratory features of brucellosis in two university hospitals in Southeast Turkey. Trop Doct 2006; 36: 49-51.
  • Aygen B, Doganay M, Sümerkan B, Yildiz O, Kayabas U. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Mal Infect 2002; 32: 485-93.
  • Sari I, Altuntas F, Hacioglu S, Kocyigit I, Sevinc A, Sacar S et al. 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. Am J Hematol 2008; 83: 334-9.
  • Young JE. Brucella species. In: Mandell GL, Benneth JE, Dolin R, editors. Principles and Practice of Infectious Diseases. 5thed. Philadelphia: Churchill Livingstone; 2000. pp. 2386-93.
  • Tasbakan MI, Yamazhan T, Gökengin D, Arda B, Sertpolat M, Ulusoy S et al. Brucellosis: a retrospective evaluation. Trop Doct 2003; 33: 151-3.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Hematological Complications in 787 Cases of Acute Brucellosis in Eastern Turkey

Ali İrfan BARAN, Hayrettin AKDENİZ, Ömer EVİRGEN, Hasan KERSEN, M. Kasım KARAHOCAGİL, Ahmet DURMUŞ, İmdat DİLEK

Oxidative Stress of Radioiodine Treatment in Patients with Hyperthyroidism

Burçin Aşkım GÜMÜŞ, Mustafa YILDIZ, Ekrem ÇİÇEK, Erol EROĞLU, Celal ÇERÇİ, Namık DELİBAŞ, Süreyya ÇERÇİ

Ear Lobule Flap for Reconstruction of a Near Total Auricle Defect

Birol CİVELEK, Tayyar SELÇUK, Ercan DEMİRBAĞ, Uğur ÇAKMAK, Salim ÇELEBİOĞLU

Abnormal Uterine Bleeding in Adolescents: Treatment with Combined Oral Contraceptive Pills is Effective Even in Hospitalized Patients with Bleeding Disorders

Ali HABERAL, M. Metin ALTAY

What Influences Herbal Medicine Use? - Prevalence and Related Factors

Alis ÖZÇAKIR, Mümtaz MAZICIOĞLU, Ayfer O. BOZKAYA, Ayfer GEMALMAZ, Serpil AYDIN, Ahmet ÖZTÜRK

Assessment of Mental Health of University Students with GHQ-12

Sarp ÜNER, Sabahat TEZCAN, T.Gökhan TELATAR, Hilal ÖZCEBE

Clinical and Rhinoscintigraphic Evaluation of Oral Macrolides in the Management of Sinonasal Polyposis

Muharrem DAĞLI, Engin DURSUN, Güleser SAYLAM, Emine AYDIN, Hülya ORTAPAMUK, Adil ERYILMAZ, Hakan KORKMAZ

Unexpected Complication Due to Shigella flexneri in a Child: Acute Appendicitis

Cüneyt TAYMAN, Burhan KÖSEOĞLU, Ferhat ÇATAL, Alpaslan TONBUL, Emine METE

Neural Tube Defects and 19 bp Deletion Within Intron-1 of Dihydrofolate Reductase Gene

Saadet ARSAN, Gülhis DEDA, Mesiha EKİM, Nejat AKAR, Ece AKAR, Yonca EĞİN

Serum Dehydroepiandrosterone Sulfate Usage for Early Detection of Prostate Cancer in Men with Serum Prostate Specific Antigen Level between 2.5 and 4.0 ng/ml: A Pilot Study

Altuğ TUNCEL, Erdem KARABULUT, Ümit TEKDOĞAN, Metin Burçin UZUN, Yılmaz ASLAN, Ali ATAN