Sari Ismail, Kocyigit Ismail, Altuntas Fevzi, Kaynar Leylagul, Eser Bulent
Department of Hematology, Faculty of Medicine, Pamukkale University, Denizi, Turkey.
Intern Med. 2008;47(11):1043-5. doi: 10.2169/internalmedicine.47.1000. Epub 2008 Jun 2.
Brucellosis can mimic several primary hematological diseases. Mild anemia and leukopenia have been frequently associated with acute brucellosis, but pancytopenia, thrombocytopenia, and hemolysis are less frequently seen. To our knowledge, brucellosis has not previously been described in association with Coombs-positive autoimmune hemolytic anemia. Here, we report a case of acute brucellosis presenting with coombs-positive autoimmune hemolytic anemia. The patient responded well to short-term pulse corticosteroid therapy followed by antibrucellosis treatment. We suggest that Brucella infection may be the probable cause of the immune hemolytic anemia in this patient. Therefore, the differential diagnosis of Coombs-positive autoimmune hemolytic anemia should include brucellosis, especially in areas where the disease is endemic.
布鲁氏菌病可类似几种原发性血液系统疾病。轻度贫血和白细胞减少症常与急性布鲁氏菌病相关,但全血细胞减少、血小板减少和溶血则较少见。据我们所知,此前尚未有布鲁氏菌病与抗人球蛋白试验阳性的自身免疫性溶血性贫血相关的报道。在此,我们报告一例伴有抗人球蛋白试验阳性的自身免疫性溶血性贫血的急性布鲁氏菌病病例。该患者对短期脉冲式皮质类固醇治疗及随后的抗布鲁氏菌病治疗反应良好。我们认为布鲁氏菌感染可能是该患者免疫性溶血性贫血的可能病因。因此,抗人球蛋白试验阳性的自身免疫性溶血性贫血的鉴别诊断应包括布鲁氏菌病,尤其是在该病的地方性流行地区。