title: Human granulocytic anaplasmosis and macrophage activation.
abstract: Patients with human granulocytic anaplasmosis present with fever, thrombocytopenia, leukopenia, and an elevated aspartate transaminase level. Clinical and histopathologic features of severe disease suggest macrophage activation. Twenty-nine patients with human granulocytic anaplasmosis had higher ferritin, interleukin-10, interleukin-12 p70, and interferon- gamma levels than did control subjects matched for age and sex; severity correlated with triglyceride, ferritin, and interleukin-12 p70 levels. Several severely affected patients had cases that fulfilled macrophage activation syndrome diagnostic criteria. Macrophage activation and excessive cytokine production may belie tissue injury associated with Ananplasma phagocytophilum infection.
authors.affiliation: Division of Medical Microbiology, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. sdumler@jhmi.edu
authors.forename: J Stephen
authors.initials: JS
authors.lastname: Dumler
authors.forename: Nicole C
authors.initials: NC
authors.lastname: Barat
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Barat
authors.forename: Johan S
authors.initials: JS
authors.lastname: Bakken
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D041081:Anaplasma phagocytophilum / Q000302:isolation & purification*; D000712:Anaplasmosis / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D016207:Cytokines / Q000032:analysis; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D005293:Ferritins / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008262:Macrophage Activation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D014280:Triglycerides / Q000032:analysis
chemical_list: D015415:Biomarkers; D016207:Cytokines; D004269:DNA, Bacterial; D014280:Triglycerides; D005293:Ferritins