CLINICAL-IMMUNOLOGIC CHARACTERISTICS OF ACUTE BRUCELLOSIS IN CHILDREN

• Main Author: D. R. Atakhodjayeva
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2013-12-01
• Series: Zaporožskij Medicinskij Žurnal
• Subjects: brucellosis; clinical immunology; cytokine status; children
• Online Access: http://zmj.zsmu.edu.ua/article/view/20540/18120

Background: Brucellosis is acute zoonotic, multi-systemic infection caused by Brucella bacteria kind. Brucellosis is met everywhere on all continents of the world, especially in the countries where livestock sector is developed. Nowadays in spite of significant success in the struggle against brucellosis this infection is a social problem. Brucellosis has specific clinical manifestations during various age periods. Problems interrelated with the study of the pathogenesis of brucellosis infection, particularly immune genesis, defining the progress and the outcome of the disease have great importance. Object of the research: to study peculiarities of the progress of acute brucellosis in children taking into account clinical-immunologic data. Materials and methods of the research: the research was based on the results of examinations of 23 children from 3 to 14 years old with brucellosis mostly living in endemic foci of the Republic of Uzbekistan. The diagnosis was defined based on epidemiologic anamnesis, clinical symptoms and laboratory data. All examined children got the analysis of detailed blood immunogramm. The corresponding data of 20 healthy children served to be controlling ones. Results and discussion: The analysis of epidemiologic anamnesis showed, that 78.3% of the examined patients with brucellosis were villagers keeping sheep, goats and cattle. In 73.9% cases source of infection was sheep and goats, 8.7% - cattle, and in 17.4% cases we could observe mixed type of infection. 78% of patients applied to hospital during prodromal period. Main complaints were weakness, frustration, headache, fatigue, bad appetite. These symptoms lasted not more than 3-5 days, after which there were symptoms of intoxication of organism with the rise of cardinal symptoms such as fever with chill (100%), arthalgia (69%), slight sweating (70%), hepato-lienal syndrome (68%). 32.9% of patients had tachycardia. Objective visual examination showed enlargement of lymphatic nodes (submaxillary, inguinal and axillary) in 73.8% of children with brucellosis. That category of children had lymphatic nodes of average consistence, painless, from pea to a bean size. 79.1% of patients had mild hypo chrome anemia. 65% of patients had acceleration of erythrocytes sedimentation rate of various degrees. On the part of white cells of blood 43.5% patients had explicit leukopenia and 21.7% - moderate one. 30.5% of patients had normal number of leukocytes. Leukocytosis was observed in 4.3% of children with acute brucellosis. Patients with acute brucellosis had misbalance of cell-mediated and humoral immunities characterized by the decrease of T-cell and B-cell values of immunity accompanied by the activation of immunoglobulins (А, М, G). In cases of acute brucellosis together with combined immune deficiency children had significant disorders of cytokines regulation displayed in statistic increase of pro- (IL-1β, IL-6) and counter inflammatory cytokines (IL-4, IL-10), and reliable decrease of γ-interferons proving development of inflammatory process.