A Study of Cytological Changes in the Bone Marrow of Patients with Severe Fever with Thrombocytopenia Syndrome

Abstract

BackgroundPeripheral blood leucopenia and thrombocytopenia are the main manifestations in severe fever with thrombocytopenia syndrome (SFTS) patients. However, the underlying causes are poorly understood. Therefore, we aimed to investigate cytology of bone marrow samples collected from SFTS patients. Methods10 SFTS patients were identified by typical clinical manifestations, detection of peripheral blood leucopenia and thrombocytopenia, and nucleic acid-based detection of the newly identified bunyavirus. SFTS patients, along with 10 participants with acute aplastic anemia and 10 healthy volunteers were enrolled in this study after written informed consent to undergo bone marrow cytological examination.ResultsWe observed similar bone marrow properties in SFTS patients and healthy volunteers, significantly different from the characteristics observed in acute aplastic anemia patients.ConclusionSimilarities between bone marrow samples collected from SFTS patients and healthy volunteers suggest that peripheral blood leucopenia and thrombocytopenia do not result from bone marrow cell plasticity.

Severe fever with thrombocytopenia syndrome: a newly discovered emerging infectious disease

“…Serum levels of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase are elevated [1,[39][40][41][42]. No cytological changes are seen in the bone marrow of SFTS patients, suggesting that the thrombocytopenia and leukopenia of SFTS do not result from damage to haematopoietic cells [43].…”

Bone marrow findings in severe fever with thrombocytopenia syndrome: prominent haemophagocytosis and its implication in haemophagocytic lymphohistiocytosis

“…There is only one comparative study in the literature of bone marrow examination in SFTS patients and healthy volunteers, and no significant differences were found 15. In total, 10 SFTS patients underwent bone marrow aspiration, and the results were normal.…”

Severe Fever with Thrombocytopenia Syndrome Presenting with Hemophagocytic Lymphohistiocytosis

“…In addition, reports regarding the bone marrow biopsy findings of SFTS patients are available. According to QuanTai et al, among 10 patients who underwent bone marrow biopsy, none exhibited hemophagocytosis in the bone marrow aspirate [7]. In contrast, Takahashi et al reported that among five SFTS patients who underwent bone marrow biopsy, all five exhibited hemophagocytosis in the bone marrow aspirate [2].…”

“…Upon examining the relevant clinical literature published, we found a few publications reporting patients with SFTS presenting with HLH [78]. So far, there has been no case report on SFTS associated with HLH in the English literature.…”