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Cytopenia in Campylobacter jejuni Enteritis Patients

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Abstract

Campylobacter jejuni (C. jejuni) enteritis is generally self-limited, but occasionally triggers extraintestinal associated sequelae. We examined whether cytopenia is associated with C. jejuni enteritis. A retrospective case-controlled study of C. jejuni and Escherichia coli (E. coli) enteritis patients, who were microbiologically confirmed in our hospital from February 2006 to October 2017, was conducted. Leukocytopenia and thrombocytopenia were defined as statuses less than 4.0 × 109/L and 130 × 109/L during their clinical courses, respectively. Clinical and microbiological data were collected. Risk factors for cytopenia were assessed by a multivariate analysis. The two eligible cohorts comprised 138 C. jejuni (71 inpatients) and 35 E. coli (34 inpatients) enteritis patients. The prevalence of leukocytopenia or thrombocytopenia in the C. jejuni patients was 7.9% (11/138) and 5.0% (7/138), and that in the E. coli patients was 0% (0/35) and 5.7% (2/35), respectively. Leukocytopenia was more prevalent in the C. jejuni enteritis inpatients than in the E. coli inpatients, but there were no significant differences in thrombocytopenia in both cohorts. The mean minimum leukocyte values were determined after an average of three admission days in the C. jejuni inpatients. The elevations of C-reactive protein and creatinine were risk factors for thrombocytopenia and leukocytopenia, respectively. Hemophagocytosis was detected in a C. jejuni enteritis patient with cytopenia. The present study suggested that leukocytopenia is a possible extraintestinal sequela in some C. jejuni enteritis patients. Hemophagocytosis should be considered as one of underlying mechanisms when cytopenia is found in these patients.

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Fig. 1

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Abbreviations

C. jejuni :

Campylobacter jejuni

E. coli :

Escherichia coli

GBS:

Guillain-Barre syndrome

WBC:

white blood cell

Cre:

creatinine

LDH:

lactate dehydrogenase

ALT:

alanine aminotransferase

CRP:

C-reactive protein

EB:

Epstein-Barr

Ig:

immunoglobulin

PAIgG:

platelet-associated IgG

HUS:

hemolytic uremic syndrome

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Acknowledgments

We thank Harumi Matsumoto for her technical support.

Funding

This work was supported by a grant-in-aid for scientific research, KAKENHI grant number 16K10376 (K. Tajima), from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

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Author notes

  1. Shuhei Okuyama and Katsushi Tajima contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Yamagata Prefectural Central Hospital, 1800, Aoyagi, Yamagata-shi, Yamagata, 990-2292, Japan

    Shuhei Okuyama, Hiroaki Kumagai & Katsushi Tajima

  2. Department of Laboratory Medicine, Yamagata Prefectural Central Hospital, Yamagata-shi, Yamagata, Japan

    Daisuke Akaneya

Authors
  1. Shuhei Okuyama
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  2. Hiroaki Kumagai
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  3. Daisuke Akaneya
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  4. Katsushi Tajima
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Contributions

KT and SO conceived the study and designed its methodological aspects. HK treated the patient. DA performed microbiological culture. The manuscript was prepared by SO and KT. All authors approved the final manuscript.

Corresponding author

Correspondence to Katsushi Tajima.

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Conflict of Interest

The authors declare that there are no conflicts of interest.

Ethics Approval and Consent to Participate

This study was approved by the Ethics Committee of Yamagata Prefectural Central Hospital.

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Consent for the publication of this case and any additional related information was taken from the patient involved in this study.

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Okuyama, S., Kumagai, H., Akaneya, D. et al. Cytopenia in Campylobacter jejuni Enteritis Patients. SN Compr. Clin. Med. 1, 677–681 (2019). https://doi.org/10.1007/s42399-019-00109-x

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