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Importance of nonspecific laboratory tests in Brucella diagnosis

Year 2012, Volume: 3 Issue: 1, 87 - 90, 01.03.2012
https://doi.org/10.5799/ahinjs.01.2012.01.0117

Abstract

Objectives: Brucella infection doesn\'t have spesific clinical evidences, for this reason it can be confused with febrile diseases. In this study we aimed investigating the importance of diagnosis with nonspesific laboratory tests in brucellosis. Materials and methods: We retrospectively screened clinically compatible with brucellosis, standard tube agglutination (STA) and STA tests with coombs of patients sera which came to Uşak State Hospital Central Laboratory between December 2010-May 2011. As control group, we determined random 62 patients attended to the laboratory between December 2010-May 2011 with STA test results are negative and not diagnosed brucellosis. Results: C-reactive protein elevated in 54 patients (87.0%), ESR elevated in 44 patients (70.9%), AST elevated in 22 patients (35.4%), ALT elevated in 7 patients (11.2%), ferritin elevated in 19 patients (30.6%), 8 patients had anemia (12.9%) of patient group. In control group, 7 patients elevated CRP (11.2%), 10 patients elevated ESR (16.1%), 1 patient elevated AST (1.6%), 1 patient elevated ALT (1.6%), 6 patients had anemia (9.6%) and decrease in ferritin level wasn\'t detected. Conclusion: We concluded statistically significant high level of CRP, ESR, ALT, AST and ferritin support the test results too beside the spesific brucellosis tests.

References

  • Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human Brucellosis. Indian J Med Microbiol 2007;25(3):188-202.
  • Yüce A, Alp-Çavuş S. Türkiye’de Brucelloz: Genel Bakış. Klimik Derg 2006;19(3): 87-97.
  • Franco M, Mulder M, Gilman RH, Smits HL. Human brucel- losis. Lancet Infect Dis 2007; 7(12): 775-86.
  • Mantur BG, Biradar MS, Bidri RC, et al. Protean clinical manifestations and diagnostic challenges of human bru- cellosis in adults: 16 years’ experience in an endemic area. J Med Microbiol. 2006;55(7):897-903.
  • Kokoglu OF, Hosoglu S, Geyik MF, et al. Clinical and labo- ratory features of brucellosis in two university hospitals in Southeast Turkey.Trop Doct 2006;36(1):49-51.
  • Christopher S, Umapathy BL, Ravikumar KL. Brucellosis: review on the recent trends in pathogenicity and labora- tory diagnosis. J Lab Physicians 2010;2(2):55-60.
  • Sarıyıldız MA, Deveci Ö, Yula E. Acutely developed elbow arthritis in a patient with Brucellosis: Familial Mediterra- nean Fever. J Clin Exp Invest 2011;2(4); 437-40.
  • Buzgan T, Karahocagil MK, Irmak H, et al. Clinical mani- festations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis 2010;14(6):469-78.
  • Sisirak M, Hukić M, Knezević Z. Evaluation of some diag- nostic methods for the brucellosis in humans - a five year study. Prilozi 2010;31(1):91-101.
  • Mert A, Ozaras R, Tabak F, et al. The sensitivity and specificity of Brucella agglutination tests. Diagn Microbiol Infect Dis 2003;46(4):241-3.
  • Navarro JM, Mendoza J, Leiva J, Rodríguez-Contreras R, de la Rosa M. C-reactive protein as a prognostic in- dicator in acute brucellosis. Diagn Microbiol Infect Dis 1990;13(3):269-70.
  • Pourbagher MA, Pourbagher A, Savas L, et al. Clinical pattern and abdominal sonographic findings in 251 cases of brucellosis in southern Turkey. AJR Am J Roentgenol 2006;187(2):191-4.
  • Khateeb MI, Araj GF, Majeed SA, Lulu AR. Brucella ar- thritis: a study of 96 cases in Kuwait. Ann Rheum Dis 1990;49(12):994-8.
  • Gür A, Geyik MF, Dikici B, et al. Complications of brucello- sis in different age groups: a study of 283 cases in south- eastern Anatolia of Turkey. Yonsei Med J 2003;44(1):33- 44.
  • Bosilkovski M, Krteva L, Dimzova M, Vidinic I, Sopova Z, Spasovska K. Human brucellosis in Macedonia - 10 years of clinical experience in endemic region. Croat Med J 2010;51(4):327-36.
  • Turunc T, Demiroglu YZ, Kizilkilic E, Aliskan H, Boga C, Arslan H. A case of disseminated intravascular coagula- tion caused by Brucella melitensis. J Thromb Thromboly- sis 2008;26(1):71-3.
  • Farah RA, Hage P, Al Rifai A, Afif C. Immune thrombocy- topenic purpura associated with brucellosis. Case report and review of the literature. J Med Liban 2010;58(4):241- 3.
  • Hasanjani Roushan MR, Mohrez M, Smailnejad Gangi SM, Soleimani Amiri MJ, Hajiahmadi M. Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran. Epidemiol Infect 2004;132(6):1109-14.
  • Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005;352(10):1011-23.
  • Coenen JL, van Dieijen-Visser MP, van Pelt J, et al. Mea- surements of serum ferritin used to predict concentra- tions of iron in bone marrow in anemia of chronic dis- ease. Clin Chem 1991;37(4):560-3.
  • Arica V, Silfeler I, Arica S, Tutanç M, Motor VK, Inci M. Brucellosis with very high ferritin levels: Report of five cases. Hum Exp Toxicol 2012;31(1):104-6.
  • Zarychanski R, Houston DS. Anemia of chronic disease: a harmful disorder or an adaptive, beneficial response? CMAJ 2008;179(4):333-7.

Brusellozda spesifik olmayan laboratuvar testlerinin tanıdaki önemi

Year 2012, Volume: 3 Issue: 1, 87 - 90, 01.03.2012
https://doi.org/10.5799/ahinjs.01.2012.01.0117

Abstract

Amaç: Brusella enfeksiyonlarının ayırt edici klinik özelliği olmadığından, ateşle seyreden hastalıklarla karışır. Bu çalışmada, brusellozlu hastalarda tanıya spesifik olmayan laboratuvar testlerinin tanıdaki değerini saptamak amaçlanmıştır. Gereç ve yöntem: Aralık 2010-Mayıs 2011 tarihleri arasında Uşak Devlet Hastanesi Merkez Laboratuvari\'na gelen, klinik olarak brusellozla uyumlu, Standart Tüp Aglütinasyon (STA) testi ve Coombslu STA testi çalışılan hasta örnekleri geriye dönük olarak tarandı. Kontrol grubu olarak Aralık 2010-Mayıs 2011 tarihleri arasında laboratuvara başvuran, STA testi sonucu negatif olan, bruselloz tanısı olmayan 62 hasta rastgele belirlendi. Bulgular: Hasta grubunun 54\'ünde (%87.0) CRP yüksekliği, 44\'ünde (%70.9) ESH yüksekliği, 22\'sinde (%35.4) AST yüksekliği, 7\'sinde (%11.2) ALT yüksekliği, 19\'unda (%30.6) Ferritin yüksekliği, 8\'inde (%12.9) anemi saptandı. Kontrol grubunun 7\'sinde (%11.2) CRP yüksekliği, 10\'unda (%16.1) ESH yüksekliği, 1\'inde (%1.6) AST yüksekliği, 1\'inde (%1.6) ALT yüksekliği, 6\'sında (%9.6) anemi saptanırken, ferritin düşüklüğü saptanan hasta olmadı. Sonuç: Sonuç olarak, brusellozda tanıya spesifik testlerin yanında, çalışmamızda istatistiksel olarak anlamlı bulunan CRP, ESH, ALT, AST ve ferritin yüksekliğinin de tanıyı destekleyici testler olarak kullanılabileceği sonucuna varılmıştır.

References

  • Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human Brucellosis. Indian J Med Microbiol 2007;25(3):188-202.
  • Yüce A, Alp-Çavuş S. Türkiye’de Brucelloz: Genel Bakış. Klimik Derg 2006;19(3): 87-97.
  • Franco M, Mulder M, Gilman RH, Smits HL. Human brucel- losis. Lancet Infect Dis 2007; 7(12): 775-86.
  • Mantur BG, Biradar MS, Bidri RC, et al. Protean clinical manifestations and diagnostic challenges of human bru- cellosis in adults: 16 years’ experience in an endemic area. J Med Microbiol. 2006;55(7):897-903.
  • Kokoglu OF, Hosoglu S, Geyik MF, et al. Clinical and labo- ratory features of brucellosis in two university hospitals in Southeast Turkey.Trop Doct 2006;36(1):49-51.
  • Christopher S, Umapathy BL, Ravikumar KL. Brucellosis: review on the recent trends in pathogenicity and labora- tory diagnosis. J Lab Physicians 2010;2(2):55-60.
  • Sarıyıldız MA, Deveci Ö, Yula E. Acutely developed elbow arthritis in a patient with Brucellosis: Familial Mediterra- nean Fever. J Clin Exp Invest 2011;2(4); 437-40.
  • Buzgan T, Karahocagil MK, Irmak H, et al. Clinical mani- festations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis 2010;14(6):469-78.
  • Sisirak M, Hukić M, Knezević Z. Evaluation of some diag- nostic methods for the brucellosis in humans - a five year study. Prilozi 2010;31(1):91-101.
  • Mert A, Ozaras R, Tabak F, et al. The sensitivity and specificity of Brucella agglutination tests. Diagn Microbiol Infect Dis 2003;46(4):241-3.
  • Navarro JM, Mendoza J, Leiva J, Rodríguez-Contreras R, de la Rosa M. C-reactive protein as a prognostic in- dicator in acute brucellosis. Diagn Microbiol Infect Dis 1990;13(3):269-70.
  • Pourbagher MA, Pourbagher A, Savas L, et al. Clinical pattern and abdominal sonographic findings in 251 cases of brucellosis in southern Turkey. AJR Am J Roentgenol 2006;187(2):191-4.
  • Khateeb MI, Araj GF, Majeed SA, Lulu AR. Brucella ar- thritis: a study of 96 cases in Kuwait. Ann Rheum Dis 1990;49(12):994-8.
  • Gür A, Geyik MF, Dikici B, et al. Complications of brucello- sis in different age groups: a study of 283 cases in south- eastern Anatolia of Turkey. Yonsei Med J 2003;44(1):33- 44.
  • Bosilkovski M, Krteva L, Dimzova M, Vidinic I, Sopova Z, Spasovska K. Human brucellosis in Macedonia - 10 years of clinical experience in endemic region. Croat Med J 2010;51(4):327-36.
  • Turunc T, Demiroglu YZ, Kizilkilic E, Aliskan H, Boga C, Arslan H. A case of disseminated intravascular coagula- tion caused by Brucella melitensis. J Thromb Thromboly- sis 2008;26(1):71-3.
  • Farah RA, Hage P, Al Rifai A, Afif C. Immune thrombocy- topenic purpura associated with brucellosis. Case report and review of the literature. J Med Liban 2010;58(4):241- 3.
  • Hasanjani Roushan MR, Mohrez M, Smailnejad Gangi SM, Soleimani Amiri MJ, Hajiahmadi M. Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran. Epidemiol Infect 2004;132(6):1109-14.
  • Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005;352(10):1011-23.
  • Coenen JL, van Dieijen-Visser MP, van Pelt J, et al. Mea- surements of serum ferritin used to predict concentra- tions of iron in bone marrow in anemia of chronic dis- ease. Clin Chem 1991;37(4):560-3.
  • Arica V, Silfeler I, Arica S, Tutanç M, Motor VK, Inci M. Brucellosis with very high ferritin levels: Report of five cases. Hum Exp Toxicol 2012;31(1):104-6.
  • Zarychanski R, Houston DS. Anemia of chronic disease: a harmful disorder or an adaptive, beneficial response? CMAJ 2008;179(4):333-7.
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Güliz Doğan Toklu This is me

Arzu Etem Akağaç This is me

Harun Ağca This is me

Publication Date March 1, 2012
Published in Issue Year 2012 Volume: 3 Issue: 1

Cite

APA Toklu, G. D., Akağaç, A. E., & Ağca, H. (2012). Brusellozda spesifik olmayan laboratuvar testlerinin tanıdaki önemi. Journal of Clinical and Experimental Investigations, 3(1), 87-90. https://doi.org/10.5799/ahinjs.01.2012.01.0117
AMA Toklu GD, Akağaç AE, Ağca H. Brusellozda spesifik olmayan laboratuvar testlerinin tanıdaki önemi. J Clin Exp Invest. March 2012;3(1):87-90. doi:10.5799/ahinjs.01.2012.01.0117
Chicago Toklu, Güliz Doğan, Arzu Etem Akağaç, and Harun Ağca. “Brusellozda Spesifik Olmayan Laboratuvar Testlerinin tanıdaki önemi”. Journal of Clinical and Experimental Investigations 3, no. 1 (March 2012): 87-90. https://doi.org/10.5799/ahinjs.01.2012.01.0117.
EndNote Toklu GD, Akağaç AE, Ağca H (March 1, 2012) Brusellozda spesifik olmayan laboratuvar testlerinin tanıdaki önemi. Journal of Clinical and Experimental Investigations 3 1 87–90.
IEEE G. D. Toklu, A. E. Akağaç, and H. Ağca, “Brusellozda spesifik olmayan laboratuvar testlerinin tanıdaki önemi”, J Clin Exp Invest, vol. 3, no. 1, pp. 87–90, 2012, doi: 10.5799/ahinjs.01.2012.01.0117.
ISNAD Toklu, Güliz Doğan et al. “Brusellozda Spesifik Olmayan Laboratuvar Testlerinin tanıdaki önemi”. Journal of Clinical and Experimental Investigations 3/1 (March 2012), 87-90. https://doi.org/10.5799/ahinjs.01.2012.01.0117.
JAMA Toklu GD, Akağaç AE, Ağca H. Brusellozda spesifik olmayan laboratuvar testlerinin tanıdaki önemi. J Clin Exp Invest. 2012;3:87–90.
MLA Toklu, Güliz Doğan et al. “Brusellozda Spesifik Olmayan Laboratuvar Testlerinin tanıdaki önemi”. Journal of Clinical and Experimental Investigations, vol. 3, no. 1, 2012, pp. 87-90, doi:10.5799/ahinjs.01.2012.01.0117.
Vancouver Toklu GD, Akağaç AE, Ağca H. Brusellozda spesifik olmayan laboratuvar testlerinin tanıdaki önemi. J Clin Exp Invest. 2012;3(1):87-90.