title: Haemophagocytosis in a patient with Crimean Congo haemorrhagic fever.
abstract: Crimean-Congo haemorrhagic fever (CCHF) is a severe disease with a case fatality of 2.8 to 80 %. A patient dwelling in an endemic region for CCHF was admitted with fever preceding bleeding diathesis and pancytopenia. Despite no history of tick exposure, CCHF was highly suspected. With an oral ribavirin therapy, clinical and laboratory improvements were obtained. The diagnosis was confirmed by detection of IgM antibody to CCHF virus and positive RT-PCR. Although the main pathogenesis of CCHF infection is not elucidated yet, haemophagocytosis, a symptom rarely reported in viral haemorrhagic fevers, was observed in this case. Haemophagocytosis is suggested to have a role in the development of pancytopenia in CCHF, the mechanism of which still needs to be investigated, probably with cytokine studies. Together with clinical symptoms and patient history, haemophagocytosis may be an indicator for CCHF.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Atahan
authors.initials: A
authors.lastname: Cagatay
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Mahir
authors.initials: M
authors.lastname: Kapmaz
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Asli
authors.initials: A
authors.lastname: Karadeniz
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Seniha
authors.initials: S
authors.lastname: Basaran
authors.affiliation: Department of Internal Medicine, Division of Hematology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yenerel
authors.affiliation: Department of Internal Medicine, Division of Hematology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Yavuz
authors.affiliation: Department of Microbiology and Clinical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Midilli
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Halit
authors.initials: H
authors.lastname: Ozsut
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Haluk
authors.initials: H
authors.lastname: Eraksoy
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Semra
authors.initials: S
authors.lastname: Calangu
mesh_terms: D000328:Adult; D015415:Biomarkers; D001792:Blood Platelets / Q000276:immunology; D001853:Bone Marrow / Q000503:physiopathology*; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000472:pathogenicity*; D006479:Hemorrhagic Fever, Crimean / Q000276:immunology / Q000503:physiopathology*; D006644:Histiocytes / Q000276:immunology*; D006801:Humans; D009504:Neutrophils / Q000276:immunology; D010587:Phagocytosis
chemical_list: D015415:Biomarkers