Laboratory investigation of reactive plasmacytosis in patients with severe fever with throbocytopenia syndrome / 中华传染病杂志

Objective To investigate the immunological characteristics and clinical significance of reactive plasmacytosis in patients with severe fever with throbocytopenia syndrome (SFTS).Methods Bunyavirus-infected patients who were diagnosed with SFTS were collected from March 2015 to October 2015 in Taizhou Hospital.Morphology analysis of bone marrow and peripheral blood (PB) smear, as well as flow cytometry analysis of plasma cell immune phenotype from peripheral blood were conducted.Serum immunoglobulin levels and helper T hymphocytes (Th)1/Th2 cytokine expressions were detected.Mann-Whitney U test was used.Results PB plasma cells from all of the SFTS patients increased in varying degrees, and the phenotype of the plasma cells was CD19+CD38++CD45+CD138+, which indicated normal mature plasma cells.The ratio of PB plasma cells was >0.030 in 10/16 patients, and >0.300 in 2/16 patients.The ratios of PB plasma cells in the patients with severe and critical groups were significantly higher than that in the mild group (0.052 vs 0.016, P0.05).The serum IgG, IgA and IgM levels did not increase in acute stage, with the median of 11.6 g/L, 2.56 g/L and 1.60 g/L (reference value 0.46 to 3.04 g/L), respectively.Conclusion The patients with SFTS show excessive humoral and cellular immunity, and the severity of disease is positively correlated with the ratio of peripheral plasma cells and the levels of cytokines IL-6 and IL-10.

The bone marrow morphology characteristics and the clinical significance of six patients with severe fever with thrombocytopenia syndrome / 中华传染病杂志

Objective To investigate the bone marrow morphology characteristics in patients with severe fever with thrombocytopenia syndrome (SFTS)and to evaluate the clinical value of bone marrow morphology examination in the diagnosis of SFTS.Methods The bone marrow morphology and clinical data of six newly diagnosed SFTS patients with positive test of novel bunyavirus infection admitted to Taizhou Hospital from July 2011 to November 2014 were retrospectively analyzed.Results The increased ratio of lymphoid and monocytoid histiocytes (0.02 - 0.23 )and hemophagocytic phenomenon were observed in all of the six patients′ bone marrow smears.Two of the six cases were diagnosed with hemophagocytic lymphohistiocytosis (HLH)according to the clinical diagnosis criteria and the remaining four cases were defined as highly suspected HLH.Conclusions The progression of SFTS disease might be closely related with HLH induced by novel bunyavirus infection.Morphology examination of bone marrow smear is beneficial for the early differential diagnosis of SFTS.