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      Usefulness of Blood Parameters for Preliminary Diagnosis of Brucellosis

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          Abstract

          Background

          Human brucellosis is a multisystem disease with a wide range of clinical signs which often leads to misdiagnosis and treatment delay. Early diagnosis of this disease can prevent the serious complications and mismanagements. This study aimed to evaluate the hematological parameters with predictive value for the diagnosis of brucellosis.

          Methods

          In this prospective case–control study which was done during 2015–2017 in Imam Reza Hospital, Kermanshah Province, west Iran, 100 patients with a confirmed diagnosis of brucellosis (brucellosis group) and 100 healthy individuals (control group) were studied. The hematological parameters, including hemoglobin (Hb), red blood cell (RBC), white blood cell (WBC) count, lymphocyte count, neutrophil count, platelet count (PLTs), mean platelet volume (MPV), platelet distribution width (PDW), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) of both groups were recorded. The data were statistically compared between the brucellosis and the control groups.

          Results

          The mean age of patients and healthy groups was 44.04 ± 23.11 and 37.92 ± 24.80, respectively (P = 0.062). The WBC, CRP and neutrophil counts were significantly higher in the brucellosis group (P < 0.05). Based on the receiver operating characteristic (ROC) analysis, the sensitivity and specificity were 54% and 66% for the WBC, 45% and 71% for the neutrophil and 65% and 72% for the CRP, respectively. There was no statistically significant difference between the two groups in terms of Hb, RBC, WBC, lymphocyte and platelet count, MPV, PDW and ESR (P > 0.05).

          Conclusion

          The results of this study indicate that WBC, CRP and neutrophil count can be used as valuable markers in the preliminary diagnosis of brucellosis. However, further researches are required to standardize these parameters for various forms of brucellosis.

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          Most cited references32

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          Platelets in Inflammation: Regulation of Leukocyte Activities and Vascular Repair

          There is now a large body of evidence that platelets are central actors of inflammatory reactions. Indeed, platelets play a significant role in a variety of inflammatory diseases. These diseases include conditions as varied as atherosclerosis, arthritis, dermatitis, glomerulonephritis, or acute lung injury. In this context, one can note that inflammation is a convenient but imprecise catch-all term that is used to cover a wide range of situations. Therefore, when discussing the role of platelets in inflammation, it is important to clearly define the pathophysiological context and the exact stage of the reaction. Inflammatory reactions are indeed multistep processes that can be either acute or chronic, and their sequence can vary greatly depending on the situation and organ concerned. Here, we focus on how platelets contribute to inflammatory reactions involving recruitment of neutrophils and/or macrophages. Specifically, we review past and recent data showing that platelets intervene at various stages of these reactions to regulate parameters such as endothelial permeability, the recruitment of neutrophils and macrophages and their effector functions, as well as inflammatory bleeding. The mechanisms underlying these various modulating effect of platelets are also discussed.
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            C-reactive protein, inflammation, and innate immunity.

            The circulating acute phase reactant C-reactive protein (CRP) has traditionally been characterized as an effector of nonclonal host resistance since it activates the classical complement cascade and mediates phagocytosis, but it is also capable of regulating inflammation. The three-dimensional structure of human CRP has revealed the molecular basis for complement activation and binding of phosphate monoesters. CRP gene expression by liver hepatocytes in response to cytokines (IL-1beta and IL-6) released in tissues requires several transcription factors which interact. Elevated levels of CRP are a prognostic marker for coronary artery disease; however, the role of CRP in atheriosclerosis remains unknown. CRP also mediates direct host protection to some microbial pathogens via its opsonic activity through certain Fcgamma-receptors. The CRP response may be one of the links between nonspecific innate immunity and specific clonal immunity.
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              Infections.

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                Author and article information

                Journal
                J Blood Med
                J Blood Med
                JBM
                jbm
                Journal of Blood Medicine
                Dove
                1179-2736
                30 March 2020
                2020
                : 11
                : 107-113
                Affiliations
                [1 ]Infectious Diseases Research Center, Kermanshah University of Medical Sciences , Kermanshah, Iran
                [2 ]Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences , Kermanshah, Iran
                [3 ]Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences , Kermanshah, Iran
                [4 ]Cardiovascular Research Center, Kermanshah University of Medical Sciences , Kermanshah, Iran
                Author notes
                Correspondence: Roya Chegenelorestani Infectious Diseases Research Center, School of Medicine, Kermanshah University of Medical Sciences , Kermanshah, Iran Tel/Fax +98 8334262252 Email lorestani25@gmail.com
                Author information
                http://orcid.org/0000-0003-2093-9317
                http://orcid.org/0000-0003-1678-6610
                http://orcid.org/0000-0001-6908-4191
                Article
                245513
                10.2147/JBM.S245513
                7125307
                32280292
                4f4feec3-518d-47a5-9a72-69cbe88d2f61
                © 2020 Akya et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 13 January 2020
                : 17 March 2020
                Page count
                Figures: 1, Tables: 2, References: 36, Pages: 7
                Categories
                Original Research

                Hematology
                brucellosis,diagnosis,blood cell count,blood parameters
                Hematology
                brucellosis, diagnosis, blood cell count, blood parameters

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