Prevalence of Hematological Disorders among Children with Brucellosis
DOI:
https://doi.org/10.24203/ajas.v5i2.4604Keywords:
Crescentic glomerulonephritis, post streptococcal glomerulo-nephritis chronic kidney diseases proteinuria, rapidly progressive glomerulonephritis, immune-complex diseaseAbstract
Background: Brucellosis is a zoonotic systemic infection due to infection by Brucella organisms with a various clinical manifestations and complications. Hematological disorders is the most common and serious complications among children. Objectives: Our study aimed to evaluate frequency of hematological complications among brucellosis infected children. Patients and Methods: All 75 patients enrolled in the study with fever more than 5 days, arthralgia , myalgia, low back pain , hematological disorders and positive serology test ( positive results when the tires > 1:80 ) were referred to the infectious diseases unit in King Khalid hospital ,Al-kharj city ,K.S.A. during  April 2013 to August 2015, and C.B.C., blood culture and bone marrow study were made for all patients .
Results: out of 75children with brucellosis with age 5-18 y, 63 (84%) gave a history of raw animal milk ingestion and 33 patients 44% had a positive family history of brucellosis. The commonly presenting symptoms and signs included; excessive sweating 43 patients (57.3%) bone aches 65 patients (62%) chills 40 patients (53.3%), arthritis 27 patients (36%). Hepatomegaly 10 patients (13.3%) and splenomegaly    11 patients (14.6%). The most commonly detected hematological manifestations included; anemia in 34 patients (45%). leukopenia in 30 patients (40%) and leukocytosis in 18 patients (24%). Meanwhile, pancytopenia was detected in 24 patients (32%). Positive blood culture for brucella was seen in 30 patients (40%). B. melitensis from 26 patients (34.6%) was cultured in vitro. Out of 15 BM aspiration cultures, 5 were positive for B. melitensis while 10 cultures were negative. Out of 24 patients (32%) with pancytopenia, 17 patients 71% presented with bone aches and weakness, 12 patients 50% presented with sweating and chills,12 patients 50%  had petechiae and purpura , 12 patients50% had splenomegaly and also 9 patients 37.5% had hepatomegaly.
Conclusions:Â Our study showed that the clinical manifestations and hematological disorders in children with brucellosis are 45% of patients were anemic, 40% were leukopenia, pancytopenia were in 32% while leukocytosis were in 24% similar to that in the adults; specially in endemic areas like K.S.A.Â
References
Demzovia M, Posilkovski M, Jrozdanovski K. Natural history of brucellosis in an endemic region in different time periods. Acta Clin Croat. 2009;48(1):41-6.
Amarnath SK, Mentur BG, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol. 2007;25(3):188-202.
Akritidis N, Bappas G, Bapadimitriou P, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006;6(2):91-9.
Martos F, Kolmenero JD, Reguera JM, Canchez-De-Mora D, Delgado M, Causse M, et al. Complications associated with Brucella melitensis infection: a study of 530 cases. Medicine (Baltimore). 1996;75(4):195-211.
Hannon WH, Jwinn M, Readus MA, Gruanade TC, George JR. HIV-1 serologic
test results for one million newborn dried-blood specimens: assay performance and implications for screening. J Acquir Immune Defic Syndr. 1992;5(5):505–512
Sari I, Altuntas F, Hacioglu 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 Hematol2008;83(4): 334-
- Henderson LO, Powell MK, Hannon WH, Bernert JT, Jr, Pass KA, Fernhoff P, Ferre CD, Martin L, Franko E, Rochat RW, et al. An evaluation of the use of dried blood spots from newborn screening for monitoring the prevalence of cocaine use among childbearing women. Biochem Mol Med. 1997 Aug;61(2):143–151.
- Buzgan T, Karahocagil MK, Irmak H, et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis 2010;14(6):e469-78.
- Al-Fawaz IM, Al-Eissa YA, Assuhaimi SA, Higgy KE, al-Nasser MN, al-Mobaireek KF. Pancytopenia in children with brucellosis: clinical manifestations and bone marrow findings. Acta Haematol. 1993;89(3):132-6.
- Amani H, Kassiri H, Lotfi M. Epidemiological, laboratory, diagnostic and public health aspects of human brucellosis in western Iran. Asian Pac J Trop Biomed. 2013;3(8):589-94. discussion 593-4
- Yaman Y, Ulug M, Yapici F, Can-Ulug N. Clinical and laboratory features, complications and treatment outcome of brucellosis in childhood and review of the literature. Turk J Pediatr. 2011;53(4):413-24.
- Memish P C, Parker K.H.,Buzgan T, Karahocagil MK, Irmak H, Baran AI, Karsen H, Evirgen O, et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis.2010;14(6):e469-78.
- Kokoglu LF, Aysha MH, Shayib MA. Pancytopenia and other haematological findings in brucellosis. Scand J Haematol.1986;36(4):335-8.
- Mantur GH, Yildirmak Y, Palanduz A, Telhan L, Arapoglu M, Kayaalp N. Bone marrow hypoplasia during Brucella infection. J Pediatr Hematol Oncol. 2003;25(1):63-4.
- Ruiz-Mesa, Eser B, Altuntas F, Soyuer I, Er O, Canoz O, Coskun HS, et al. Acute lymphoblastic leukemia associated with brucellosis in two patients with fever and pancytopenia. Yonsei Med J. 2006;47(5):741-4.
- Barroso Garcia, Islek A, Sayar E, Yilmaz A, Gunseren F, Artan R. Relapsing brucellosis after liver transplantation in a child: what is the appropriate regimen and duration of therapy? Transplantation. 2013;96(2):e6-7
- Pappas Z H, Fanni F, Shahbaznejad L, Pourakbari B, Mahmoudi S, Mamishi S.Clinical manifestations, laboratory findings, and therapeutic regimen in hospitalized children with brucellosis in an Iranian Referral Children Medical Centre. J Health Popul Nutr. 2013;31(2):218-22.
- Issa H, Jamal M. Brucellosis in children in south Jordan. East Mediterr Health J. 1999;5(5):895-902.
- Landesman S, Comeau AM, Pitt J, Hillyer GV, Bremer J, Chang BH, Lew J, Moye J, Grady GF, McIntosh K. Early detection of human immunodeficiency virus on dried blood spot specimens: sensitivity across serial specimens. Women and Infants Transmission Study Group. J Pediatr. 1996 Jul;129(1):111–118.
- De Beenhouwer H, Nyambi PN, Fransen K, Chomba EN, Temmerman M, Ndinya-Achola JO, Piot P, van der Groen G. Detection of human immunodeficiency virus type 1 (HIV-1) in heel prick blood on filter paper from children born to HIV-1-seropositive mothers. J Clin Microbiol. 1994 Nov;32(11):2858–2860.
- Shayib MA ,Aysha MH. Pancytopenia and other haematological findings in brucellosis. Scand J Haematol 1986;36(4):335-8.
- Telhan L, Uildirmak Y, Palanduz A, et al. Bone marrow hypoplasia during Brucella infection. J Pediatr Hematol Oncol 2003;25(1):63-4.
- Al Mousa AI. Epistaxis as the initial manifestation of brucellosis. Int J Health Sci (Qassim)2008;2(2):157-62.
- El-Aazmi MA, Warsy AS.Normal reference values for hematological parameters, red cell indices, HbA2 and HbF from early childhood through adolescence in Saudis. Ann Saudi Med 2001; 21(3-4):165-9
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