Karaman Kamuran, Akbayram Sinan, Kaba Sultan, Karaman Serap, Garipardiç Mesut, Aydin Ilyas, Öner Ahmet Fayik
Department of Pediatric Hematology, Yuzuncu Yil University, Van, Turkey.
Department of Pediatrics, Yuzuncu Yil University, Van, Turkey.
Infez Med. 2016 Jun 1;24(2):123-30.
This retrospective study included seven paediatric cases aged from 4 to 14 (10.2±3.4) years with pathologically proved haemophagocytic lymphohistiocytosis from a single institution during 2009 and 2013. Over this time period, 496 patients with brucellosis were diagnosed. None of the patients (3 boys and 4 girls) had a history of any haematologic disorder. All patients had an anamnesis for recently consumed unpasteurised homemade dairy products or had a contact history with sheep and/or cows. The diagnosis of brucellosis was confirmed by standard tube agglutination test in all patients; titres were 1: 1280 in seven patients. Blood culture was positive for Brucella melitensis in three patients (42%). Bone marrow cultures were positive for B. melitensis in four patients (57%). Fever was present in all patients (100%) with haemophagocytic lymphohistiocytosis. The other most common symptoms were malaise, myalgia, anorexia, sweating and weight loss. In addition, sweating was observed in five patients, and lymphadenopathy, petechiae, and weight loss were observed in one patient. Hepatomegaly, splenomegaly, and hepatosplenomegaly were found in four (57%), six (85%) and four (57%), patients, respectively. Haemophagocytosis was documented in bone marrow examinations of all children except in two cases. All patients recovered completely, and their peripheral blood counts returned to normal by 2 to 4 weeks after antibiotic treatment of brucellosis.
这项回顾性研究纳入了2009年至2013年期间来自单一机构的7例年龄在4至14岁（10.2±3.4岁）、经病理证实为噬血细胞性淋巴组织细胞增生症的儿科病例。在此期间，共诊断出496例布鲁氏菌病患者。所有患者（3名男孩和4名女孩）均无任何血液系统疾病史。所有患者均有近期食用未巴氏杀菌的自制乳制品病史或与绵羊和/或奶牛有接触史。所有患者均通过标准试管凝集试验确诊为布鲁氏菌病；7例患者的滴度为1:1280。3例患者（42%）血培养布鲁氏菌羊种阳性。4例患者（57%）骨髓培养布鲁氏菌羊种阳性。所有噬血细胞性淋巴组织细胞增生症患者均有发热（100%）。其他最常见的症状为不适、肌痛、厌食、出汗和体重减轻。此外，5例患者出现出汗，1例患者出现淋巴结病、瘀点和体重减轻。分别有4例（57%）、6例（85%）和4例（57%）患者出现肝肿大、脾肿大和肝脾肿大。除2例患者外，所有儿童的骨髓检查均记录到噬血细胞现象。所有患者均完全康复，在布鲁氏菌病抗生素治疗后2至4周外周血细胞计数恢复正常。
