Severe epistaxis in brucellosis-induced isolated thrombocytopenia: A report of two cases

Sevinç, Alper; Kutlu, Nurettin Onur; Kuku, İrfan; Özgen, Ünsal; Aydogdu, Ismet; Soylu, Hanifi

doi:10.1046/j.1365-2257.2000.00334.x

Cited by 16 publications

(10 citation statements)

References 10 publications

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“…We have previously reported inter- esting cases of brucellosis in patients presenting with either initial hematological manifestations or unexplained fever that were referred to our university hospitals' hematologyoncology clinics [11][12][13][14][15][16]. Several data have been reported on the frequency and diversity of hematological abnormalities occurring in brucellosis [6,7,17].…”

Section: Discussionmentioning

confidence: 99%

A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis

et al. 2007

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The aim of the study is to review the clinical manifestations and the hematological findings of brucellosis and pancytopenia, with or without hematological malignancies. The records of 202 patients with brucellosis were evaluated retrospectively. Among these cases of brucellosis seen in a 6 year period between April 1999 and June 2005, 30 patients with pancytopenia were identified. The most common manifestation was fever, followed by weight loss, anorexia, malaise, arthralgia, and hepatosplenomegaly. Bone marrow biopsies revealed hypercellularity or normocellularity. The most common findings in the bone marrow evaluation were histiocytic hemophagocytosis and granulomas. Among all cases, we diagnosed 5 hematological malignancies (1 acute myelogenous leukemia, 2 acute lymphoblastic leukemia, and 2 multiple myeloma) concurrently with brucellosis. The clinical symptoms and findings were similar in patients with and without malignancies. In cases with malignancies, the bone marrow biopsy revealed predominant primary disease involvement. Significant increases in ESR and CRP, severe anemia and thrombocytopenia were observed in patients with malignancies. Peripheral blood counts in patients without malignancies returned to normal after antibiotic treatment for brucellosis. However, pancytopenia in two patients with malignancies did not recover because of primary resistant disease. We conclude that while histiocytic hemophagocytosis may be considered as a major cause of pancytopenia, leukemic infiltration can also be an extreme and unusual cause of pancytopenia in patients in whom brucellosis was concurrently diagnosed with hematological malignancies. Am. J. Hematol., 2008. © 2007 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis

et al. 2007

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“…Platelet recovery usually occurs within 2-3 weeks of initiation of appropriate antimicrobial therapy [3,13]. IVIg may be used primarily when clinical situations require a transient increase of the platelet count or when the use of glucocorticoids is contraindicated [14].…”

Section: Discussionmentioning

confidence: 99%

Intravenous gamma globulin is effective as an urgent treatment in Brucella‐induced severe thrombocytopenic purpura

Altuntaş¹,

Yıldız²,

Sarı³

et al. 2005

American J Hematol

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Severe thrombocytopenia is a rare hematologic manifestation of brucellosis, which can occasionally be associated with bleeding into the skin and from mucosal sites. Prompt recognition of this brucellosis complication and aggressive therapy is vital because the mortality rate associated with bleeding into the central nervous system is high. We report a case of a patient infected with Brucella melitensis who was admitted with a severe case of thrombocytopenic purpura. The patient responded well to intravenous gamma globulin (IVIg) treatment with platelet recovery within 2-3 days. For cases of Brucella-induced thrombocytopenic purpura, IVIg may be administered as an urgent therapy until the microbial therapy takes effect. Am.

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“…These mechanisms involve hypersplenism, bone marrow granulomas, hemophagocytosis and immunologically mediated bone marrow suppression, and disseminated intravascular coagulation [7–9]. The presented case was initially misdiagnosed as ITP but we could not reach a certain decision because corticosteroid administration was contraindicated.…”

Section: Discussionmentioning

confidence: 99%

An Atypical Presentation of Brucellosis in a Patient with Isolated Thrombocytopenia Complicated with Upper Gastrointestinal Tract Bleeding

Baldane

Şıvgın

Alkan

et al. 2012

Case Reports in Medicine

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A 59-year-old female patient was admitted to the emergency service with complaints of hematemesis and melena for the last few days. In laboratory tests, the platelet count was found to be 6 × 109/L. Intravenous or oral corticosteroid treatment was thought to be given for ITP but disclaimed due to upper GIS bleeding. On the 5th day of treatment, Brucella melitensis was isolated from blood culture before the results of Wright tube agglutination tests were reported positive as 1 : 80. On the second day of the anti-brucellosis treatment, the thrombocyte count was raised from 6000/mm3 to 110000/mm3, and on the 3rd day to 225000/mm3.

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Severe epistaxis in brucellosis-induced isolated thrombocytopenia: A report of two cases

Cited by 16 publications

References 10 publications

A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis

A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis

Intravenous gamma globulin is effective as an urgent treatment in Brucella‐induced severe thrombocytopenic purpura

An Atypical Presentation of Brucellosis in a Patient with Isolated Thrombocytopenia Complicated with Upper Gastrointestinal Tract Bleeding

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