Pancytopenia, a rare hematologic manifestation of brucellosis in children

KARAKUKCU M., Patiroglu T., OZDEMIR M., GUNES T., GUMUS H., KARAKUKCU C.

JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY, vol.26, no.12, pp.803-806, 2004 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 12
  • Publication Date: 2004
  • Journal Name: JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.803-806
  • Keywords: brucellosis, pancytopenia, childhood, bone marrow, hemophagocytosis, MICROANGIOPATHIC HEMOLYTIC-ANEMIA, CHILDHOOD BRUCELLOSIS, INFECTION, THROMBOCYTOPENIA
  • Erciyes University Affiliated: Yes

Abstract

The records of 54 children with brucellosis were evaluated retrospectively. Among them, eight patients (14.8%) with pancytopenia were identified in a 7-year period between 1996 and 2003. Six of the eight patients with pancytopenia had Brucella melitensis isolated from blood cultures, and all eight patients had Brucella agglutination titers of at least 1:320. Agglutination test titers did not correlate with the degree of pancytopenia. Fever was the most common manifestation, followed by malaise, anorexia, sweating, weight loss, and gastrointestinal symptoms. Most patients had hepatosplenomegaly, and bone marrow aspiration specimens showed hyper-cellularity or normocellularity. Hemophagocytosis (3 patients) and histiocytic hyperplasia (4 patients) were observed in bone marrow examinations of eight patients, but bone marrow aplasia and granulomas were not detected. All children recovered completely; the pancytopenia was transient and resolved after the antibiotic treatment of Brucella infection. Brucellosis should be considered as a possible diagnosis among patients with pancytopenia.