Broides Arnon, Shubinsky George, Yermiahu Tikva, Abu-Quider Abed, Press Joseph, Moser Asher
Pediatric Emergency Department, Soroka University Medical Center, Beer-Sheva, Israel.
J Pediatr Hematol Oncol. 2008 May;30(5):378-81. doi: 10.1097/MPH.0b013e3181639b10.
Constitutional symptoms and pancytopenia are occasionally the initial presentation of pediatric brucellosis. Therefore, in endemic areas, in children with pancytopenia, both brucellosis and malignancy should be included in the deferential diagnosis. We report here a child with pancytopenia and hepatosplenomegaly as manifestations of brucellosis in whom bone marrow morphology and flow cytometry data revealed hemophagocytosis, left shift in myeloid cells and activation changes in antigenic properties of T and B lymphocytes and monocytes. The patient had an uneventful and complete recovery after appropriate antibiotic therapy. Our report demonstrates that bone marrow and flow cytometry findings in children with brucellosis may include significant reactive changes in hematopoiesis.
全身症状和全血细胞减少偶尔是小儿布鲁氏菌病的初始表现。因此,在流行地区,对于全血细胞减少的儿童,鉴别诊断应包括布鲁氏菌病和恶性肿瘤。我们在此报告一名以全血细胞减少和肝脾肿大为布鲁氏菌病表现的儿童,其骨髓形态学和流式细胞术数据显示存在噬血细胞现象、髓系细胞左移以及T、B淋巴细胞和单核细胞抗原特性的激活变化。经适当抗生素治疗后,患者顺利完全康复。我们的报告表明,布鲁氏菌病患儿的骨髓和流式细胞术检查结果可能包括造血方面的显著反应性变化。