Human Granulocytic Anaplasmosis and Macrophage Activation

• Published in: Clinical infectious diseases Vol. 45; no. 2; pp. 199 - 204
• Main Authors: Dumler, J. Stephen, Barat, Nicole C., Barat, Christopher E., Bakken, Johan S.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.07.2007; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Anaplasma phagocytophilum - isolation & purification; Anaplasmosis - blood; Anaplasmosis - diagnosis; Anaplasmosis - epidemiology; Animal models; Articles and Commentaries; Bacteria; Biological and medical sciences; Biomarkers - blood; Case-Control Studies; Cells; Cytokines; Cytokines - analysis; DNA, Bacterial - analysis; Female; Ferritins; Ferritins - analysis; Fever; Follow-Up Studies; Humans; Incidence; Infections; Infectious diseases; Macrophage activation; Macrophage Activation - physiology; Macrophages; Male; Medical sciences; Middle Aged; Pathology; Physical trauma; Polymerase Chain Reaction - methods; Probability; Reference Values; Risk Assessment; Severity of Illness Index; Sex Distribution; Statistics, Nonparametric; Triglycerides; Triglycerides - analysis; Infection; Human; Bacteriosis; Anaplasmosis; Rickettsialosis; Macrophage
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1086/518834

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-γ 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.