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. 2014 Jan-Feb;18(1):88-91.
doi: 10.1016/j.bjid.2013年05月01日1. Epub 2013 Sep 25.

Clinical and laboratory characteristics of severe fever with thrombocytopenia syndrome in Chinese patients

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Clinical and laboratory characteristics of severe fever with thrombocytopenia syndrome in Chinese patients

Yali Weng et al. Braz J Infect Dis. 2014 Jan-Feb.

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) associated with severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging infectious disease. 12 patients with severe fever with thrombocytopenia syndrome in our study were presented mainly with fever and severe malaise. The clinical manifestations typically became worse on the 6th or 7th day. The average fever time is 9.11 ± 1.54 days. Most of them had multiorgan dysfunction, and part of them had hemophagocytic lymphohistiocytosis histiocytosis (HLH). The characteristic laboratory findings in the early stage were the drop of white blood cells (WBC), platelets (PLT) and serum Ca++, while increase of aspartate amino transferase (AST), creatine kinase (CK), and lactate dehydrogenase (LDH). CD3+CD4+ were significantly decreased, while CD3-CD56+ were significantly increased, whereas CD3+CD8+ were constantly elevated throughout the disease course. Ten to 14 days after illness onset, symptoms were improved, accompanied by resolution of laboratory abnormalities. These results indicate that severe fever with thrombocytopenia syndrome has an acute onset and self-limited course. It is a systemic infection. The host immune response caused tissues and organs injury. The improvement of symptoms and laboratory tests is consistent with the elimination of the virus and recover of immune response. Further investigation should be done in order to better understand this disease and guide the clinical treatment.

Keywords: Bunyaviridae infection; Clinical features; Laboratory characteristics; Thrombocytopenia.

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Figures

Fig. 1
Fig. 1
Change of WBC, Lymphocytes, and PLT. Changes of WBC and Lymphocyte are shown in A. Changes of PLT are shown in B.
Fig. 2
Fig. 2
Change of serum AST, LDH, and CK. LDH, CK and AST levels was increased clearly at the early stage. There is no difference of increasing of LDH, CK and AST levels between phase 1 and phase 2 (p > 0.05); but a statistical difference of these changes was found at phase 1, phase 3 (p < 0.05) and phase 4 (p < 0.01) in pair wise comparison. The statistical difference was also found at phase 2, phase 3 (p < 0.05) and phase 4 (p < 0.01) in pair wise comparison. However, statistical difference of the change of LDH (p < 0.05) was found only at phase 3 and phase 4 in pair wise comparison.
Fig. 3
Fig. 3
Flow cytometric analysis of peripheral blood lymphocyte subset counts of patients. CD3+ and CD4+ were significantly decreased in phase 1 and started to increase from phase 3, while CD3-CD56+ was significantly increased in phase1 and started to decrease from phase 3. There is a statistical difference at phase 1 and phase 3 (p < 0.05), phase1 and phase 4 (p < 0.01) of CD3-CD56+. A statistical difference was found at phase 1 and phase 3, phase 1 and phase 4, phase 2 and phase 4 (p < 0.05) in pair wise comparison of CD3+ and CD4+. CD3+CD8+ were at high level in every stage, but there was no difference in pair wise comparison (p > 0.05).

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