Evaluation of Osteoarticular Involvement Associated with Brucellosis in Children

Abstract

Aim: Brucellosis is a significant public health problem with high morbidity. Its most frequent complication is osteoarticular involvement. The study aimed to evaluate the relationship of osteoarticular involvement with clinical features and prognosis in children with brucellosis. Material and Methods: This retrospective study included pediatric patients between the ages of 1 and 18 years who were hospitalized and diagnosed with brucellosis between 2015 and 2020, and were regularly followed up. and all their findings and osteoarticular involvement data within the last two years were recorded. Clinical features, laboratory findings, osteoarticular involvement, and relapse rates of the patients were evaluated. Results: A total of 80 patients were included study. During the follow-up period, relapse developed in 14 (17.5%) patients. The most commonly affected joints were right (40%, n=32) and left (26.3%, n=21) hips, then right (27.5%, n=22) and left (23.8%, n=19) knees. Shoulder joint involvement rates and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine transaminase (ALT), and aspartate aminotransferase (AST) levels were statistically significantly higher in the relapse group (p=0.016, p=0.003, p=0.001, p<0.001, p<0.001, respectively). There was no significant difference in demographic characteristics, clinical features, and treatment responses of the patients between age groups, except weakness and sweating complaints that were high among older children (p=0.036). Conclusion: High admission ALT, AST, CRP, and ESR levels in brucellosis cases with osteoarticular involvement and the presence of shoulder joint involvement, albeit rarely, can be a warning sign in terms of relapse. Patients should be closely followed up in terms of brucellosis complications.

Keywords

• brucellosis
• osteoarthritis
• sacroiliac joint
• shoulder joint
• relapse

Çocukluk Çağı Brusellozuna İlişkin Osteoartiküler Tutulumun Değerlendirilmesi

Abstract

Amaç: Bruselloz, yüksek morbiditeye sahip önemli bir halk sağlığı sorunudur. En sık görülen komplikasyonu osteoartiküler tutulumdur. Bu çalışmanın amacı, bruselloz tanılı çocuklarda osteoartiküler tutulumun klinik özellikler ve prognoz ile ilişkisini değerlendirmektir. Gereç ve Yöntemler: Geriye dönük bu çalışmaya, 2015 ve 2020 yılları arasında bruselloz tanısıyla hastaneye yatırılan ve düzenli takipleri yapılan 1 ile 18 yaş aralığındaki pediatrik hastalar dahil edildi. Son iki yıldaki tüm bulguları ve osteoartiküler tutulum verileri kaydedildi. Hastaların klinik özellikleri, laboratuvar bulguları, osteoartiküler tutulum ve nüks oranları değerlendirildi. Bulgular: Çalışmaya toplam 80 hasta dahil edildi. Takip süresinde hastaların 14 (%17,5) hastada relaps gelişti. En sık etkilenen eklemler sağ (%40, n=32) ve sol (%26,3, n=21) kalçalar, ardından sağ (%27,5, n=22) ve sol (%23,8, n=19) dizlerdi. Omuz eklem tutulum oranları ile C-reaktif protein (CRP), eritrosit sedimantasyon hızı (ESH), alanin transaminaz (ALT) ve aspartat aminotransferaz (AST) düzeyleri relaps grubunda istatistiksel olarak anlamlı şekilde daha yüksekti (sırasıyla p=0,016, p=0,003, p=0,001, p<0,001, p<0,001). Sadece yaşı büyük çocuklarda daha yüksek olan güçsüzlük ve terleme şikayetleri dışında (p=0,036), hastaların demografik özellikleri, klinik özellikleri ve tedavi yanıtları bakımından yaş grupları arasında anlamlı bir farklılık yoktu. Sonuç: Osteoartiküler tutulumu olan bruselloz olgularında yüksek başvuru ALT, AST, CRP ve ESR düzeyleri ve nadir de olsa omuz eklem tutulumunun varlığı relaps açısından uyarıcı olabilir. Hastalar bruselloz komplikasyonları açısından yakından takip edilmelidir.

Keywords

• bruselloz
• osteoartrit
• sakroiliak eklem
• omuz eklemi
• relaps

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