Immunological Evaluation of Children with Crimean-Congo Hemorrhagic Fever in Addition to Routine Clinical and Laboratory Tests Who Were Admitted to Sivas, Cumhuriyet University

Abstract

Introduction: In our study, it was aimed to evaluate clinical and routine laboratory findings and serum immunoglobulin and complement levels of pediatric patients with the diagnosis of Crimean-Congo Hemorrhagic Fever CCHF .Materials and Methods: Medical records of 72 patients that diagnosed with CCHF proven by ELISA or polymerase chain reaction PCR in Sivas, Cumhuriyet University between 2011 and 2012 were reviewed retrospectively. The information about the epidemiological, clinical features and laboratory findings were recorded. Results: Seventy-two patients who participated in the study, mean age11.95±3.95 years came from Tokat, Sivas, Yozgat, Giresun and Erzincan. During the admission, patients mainly had fever 94.4% , vomiting 54.2% , fatigue 52.8% , anorexia 50% , headache 47.2% , upper respiratory tract infection findings 41.7% ; rarely, petechiae-purpura, ecchymosis, epistaxis, diarrhea, melena, maculopapular rash, hematemesis, hematuria, hepatomegaly, splenomegaly, lymphadenopathy were seen. At admission, laboratory findings of the patients were as follows; thrombocytopenia, 80.6%; leucopenia,70.8%; neutropenia, 50%; high aspartate transaminase, 73.6%; high alanine transaminase, 26.4%; high lactate dehydrogenase 71.6%; high creatine kinase, 68.1%; prolonged protrombine time, 54.2%; prolonged partial thromboplastin time, 52.8%. In addition low IgG, low IgA, low C3, low C4 were found in 4, 3, 12 and 1 patient respectively. All patients received intravenous fluid therapy; some received blood products. Four patients received intravenous immunoglobulin, 69 patients were treated with ribavirin. Conclusions: Clinical findings of CCHF in children are similar to those in adults; in patients with low serum immunoglobulin outside the intravenous immunoglobulin IVIG treatment, other treatments are similar in all patients. In CCHF to investigate immunodeficiency status, further large-scale study is needed.