Wang Jun-Nuan, Li Bing-Jie, Yuan Jun, Li Yan
Hebei Medical University Shijiazhuang, Hebei, China.
Department of Hematology, Hebei General Hospital Shijiazhuang, Hebei, China.
Int J Clin Exp Pathol. 2023 Jul 15;16(7):164-171. eCollection 2023.
Myelofibrosis is a myeloproliferative tumor, that can be secondary to malignant hematologic or inflammatory diseases, such as chronic myeloid leukemia, polycythemia vera, primary thrombocythemia, multiple myeloma, disseminated tuberculosis, or vasculitis. However, few cases of brucellosis-associated myelofibrosis have been reported. Moreover, due to the rarity of this phenomenon, it is often overlooked by clinicians, resulting in misdiagnosis and mismanagement. Thus, brucellosis should be considered as a possible cause of myelofibrosis. In the present study, we report five cases of brucellosis, of which three had myelofibrosis. In addition, to further determine the potential link between brucellosis and myelofibrosis, we retrospectively analyzed the levels of various cytokines by collecting the clinicopathologic data of patients and using immunohistochemical staining. We found that brucellosis patients with myelofibrosis had elevated levels of cytokines such as interferon (IFN)-γ, interleukin (IL)-1β, basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), suggesting that the regulation of cytokines may play a central role in the development of myelofibrosis in patients with brucellosis.
骨髓纤维化是一种骨髓增殖性肿瘤，可继发于恶性血液系统疾病或炎症性疾病，如慢性髓性白血病、真性红细胞增多症、原发性血小板增多症、多发性骨髓瘤、播散性结核病或血管炎。然而，布鲁氏菌病相关的骨髓纤维化病例报道较少。此外，由于这种现象罕见，临床医生常常忽视，导致误诊和管理不当。因此，布鲁氏菌病应被视为骨髓纤维化的一个可能病因。在本研究中，我们报告了5例布鲁氏菌病病例，其中3例患有骨髓纤维化。此外，为进一步确定布鲁氏菌病与骨髓纤维化之间的潜在联系，我们通过收集患者的临床病理数据并使用免疫组织化学染色，回顾性分析了各种细胞因子的水平。我们发现，患有骨髓纤维化的布鲁氏菌病患者体内细胞因子水平升高，如干扰素（IFN）-γ、白细胞介素（IL）-1β、碱性成纤维细胞生长因子（b-FGF）、血管内皮生长因子（VEGF），这表明细胞因子的调节可能在布鲁氏菌病患者骨髓纤维化的发生发展中起核心作用。
