title: Comparison of clinical and laboratory characteristics of patients fulfilling criteria for proven and probable human granulocytic anaplasmosis.
abstract: To assess the value of clinical definitions for human granulocytic anaplasmosis (HGA) epidemiological, clinical and laboratory findings in 50 adult patients with proven HGA (Anaplasma phagocytophilum isolated from blood, and/or positive PCR result, and/or seroconversion or ≥4-fold change in serum IFA antibody titres to A. phagocytophilum) and 46 patients with probable HGA (demonstration of serum antibodies to A. phagocytophilum in titres ≥1:256) were compared. Patients with proven HGA were older (55 versus 43.5 years; p = 0.001), were more often treated with doxycycline (31/50, 62% versus 11/46, 23.9%; p < 0.001), more frequently reported chills (40/50, 80% versus 17/46, 36.9%; p < 0.001), myalgia (37/50, 74% versus 21/46, 45.7%; p = 0.005) and cough (10/50, 20% versus 2/46, 4.4%; p = 0.02), and had more often abnormal laboratory findings such as thrombocytopenia (45/50, 90% versus 22/46, 47.8%; p < 0.001), abnormal liver function test results (45/50, 87% versus 22/46, 47.8%; p < 0.001), leukopenia (38/50, 76% versus 21/46, 45.7%; p = 0.002) and elevated serum CRP concentration (48/50, 96% versus 31/46, 67.4%; p < 0.001). The dissimilarities imply that in some patients fulfilling criteria for probable HGA the signs and symptoms most likely are not the result of a recent infection with A. phagocytophilum and indicate that clinical definitions used in the present study have a distinctive value.
authors.affiliation: Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia. Electronic address: stanka.lotric-furlan@mf.uni-lj.si.
authors.forename: Stanka
authors.initials: S
authors.lastname: Lotrič-Furlan
authors.affiliation: Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia.
authors.forename: Tereza
authors.initials: T
authors.lastname: Rojko
authors.affiliation: Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Slovenia.
authors.forename: Mateja
authors.initials: M
authors.lastname: Jelovšek
authors.affiliation: Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Slovenia.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Petrovec
authors.affiliation: Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Slovenia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Avšič-Županc
authors.affiliation: Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Slovenia.
authors.forename: Lara
authors.initials: L
authors.lastname: Lusa
authors.affiliation: Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia.
authors.forename: Franc
authors.initials: F
authors.lastname: Strle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D041081:Anaplasma phagocytophilum / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D000712:Anaplasmosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood* / Q000276:immunology; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017524:Slovenia; D064927:Tick Bites; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D004318:Doxycycline
keywords: Anaplasma phagocytophilum; Clinical diagnosis; Human granulocytic anaplasmosis; Probable; Proven; Slovenia