Human Granulocytic Anaplasmosis as a Cause of Febrile Illness in Korea Since at Least 2006

Jongyoun Yi Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.

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Kye-Hyung Kim Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea.

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Mee Kyung Ko Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.

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Eun Yup Lee Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea.

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Su Jin Choi Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.

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Myoung-don Oh Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.

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Human granulocytic anaplasmosis (HGA) is a tick-borne rickettsial zoonosis with fever, thrombocytopenia, and leukopenia. HGA has been reported in Korea in 2013 but it is uncertain how long it has existed. A retrospective study was conducted on patients who underwent bone marrow examination due to fever and cytopenia, with no clear hematologic or microbiologic causes, from 2003 through 2012. Laboratory diagnosis was made by detecting 16S rRNA genes of Anaplasma phagocytophilum from the stored blood samples. Among the 70 patients, five (7.1%) HGA cases were found, and the earliest case dated back to 2006. Two cases met the diagnostic criteria of hemophagocytic lymphohistiocytosis (HLH) and were fatal. Although HGA has been prevalent in Korea since at least 2006, it is not always diagnosed and has posed a possible lethal health risk to the people in Korea. HGA should be considered as a cause of fever with cytopenia or HLH.

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Author Notes

* Address correspondence to Kye-Hyung Kim, Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, South Korea 49241. E-mail: kyehyungs@gmail.com

Financial support: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2014R1A1A4A01009748).

Authors' addresses: Jongyoun Yi and Mee Kyung Ko, Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea, and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea, E-mails: socioliberal@yahoo.co.kr and qeqazwsx@hanmail.net. Kye-Hyung Kim, Department of Internal Medicine, Pusan National University School of Medicine, Busan, South Korea, and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea, E-mail: kyehyungs@gmail.com. Eun Yup Lee, Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea, E-mail: eylee@pusan.ac.kr. Su Jin Choi and Myoung-don Oh, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea, E-mails: csj6692@hanmail.net and mdohmd@snu.ac.kr.

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