Morphological characteristics of bone marrow in severe fever with thrombocytopenia syndrome: analysis of 28 cases

Abstract

Objective To assess the morphological characteristics of bone marrow in patients of severe fever with thrombocytopenia syndrome (SFTS) and its value in diagnosis. Methods The bone marrow morphology was retrospectively reviewed in 28 laboratory confirmed patients with SFTS from Zhoushan Hospital during January 2012 and December 2015. The correlation between bone marrow-derived macrophage and peripheral blood cells was analyzed with t test. Results All patients presented leukocytopenia and thrombocytopenia. Poor bone marrow hematopoietic function was observed in 23 patients (82%) showing granulocyte, erythrocyte and megakaryocyte hypoplasia, but no pathological hematopoietic disorder was observed. Eighteen patients (64%) had various degrees of increased amount of macrophage in the bone marrow; peripheral white blood cell count and platelets in patients with macrophage ≥0.5% were lower than those with macrophage <0.5%, and the difference was of statistical significance (t=3.836 and 4.499, P<0.01). Conclusion SFTS patients have characteristic bone marrow morphology, and bone marrow examination is beneficial for differentiation of SFTS from blood lymphatic system diseases and other virus infection. Key words: Bunyaviridae infections; Thrombocytopenia; Cytological examination of bone marrow