Autoimmune Neutropenia in Hodgkin's Disease

Hunter, J. D.

doi:10.1001/archinte.1982.00340150186037

Cited by 13 publications

(3 citation statements)

References 10 publications

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“…A similar pattern of results was observed in conditions in which autoimmune neutropenia was secondary to other disorders (table 1). The demon stration of opsonic activity and/or granulocyte-binding IgG or IgM antibodies in patients with autoimmune neu tropenia secondary to rheumatoid arthritis, Evan's syn drome, systemic lupus erythematosus and proliferative disorders confirms previous reports [10,11,[18][19][20]. Anti granulocyte opsonic activity and/or granulocyte-binding IgG or IgM antibodies were detected in 44/79 (55.7%) of SAN patients.…”

Section: Relationship Between Direct Gift and Indirect Gclt And Gift supporting

confidence: 88%

Prospective Evaluation of the Chemiluminescence Test for the Detection of Granulocyte Antibodies: Comparison with the Granulocyte Immunofluorescence Test

Lucas¹

1994

Vox Sanguinis

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A series of 213 neutropenic patients were tested for the presence of granulocyte antibodies using the granulocyte chemiluminescence test (GCLT) and the granulocyte immunofluorescence test (GIFT). Sera containing lymphocyte (HLA) antibodies were excluded from the study. A direct GIFT was performed on granulocytes from 56 patients. Samples were obtained from patients with a range of clinical conditions including primary adult autoimmune neutropenia, autoimmune neutropenia of infancy, autoimmune neutropenia secondary to Felty’s syndrome, rheumatoid arthritis, idiopathic thrombocytopenic purpura, systemic lupus erythematosus, proliferative disorders, bone marrow transplantation and patients with documented febrile or pulmonary transfusion reactions. Overall, granulocyte antibodies were detected in 52.1% of patient sera. Results for the GCLT and GIFT (IgG) were strongly correlated (p<0.001) for both primary and secondary immune neutropenias. The results confirm the applicability of the GCLT in the granulocyte serology laboratory.

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Section: Relationship Between Direct Gift and Indirect Gclt And Gift supporting

confidence: 88%

Prospective Evaluation of the Chemiluminescence Test for the Detection of Granulocyte Antibodies: Comparison with the Granulocyte Immunofluorescence Test

Lucas¹

1994

Vox Sanguinis

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“…Only 4 cases have been reported so far [4][5][6][7], two at the onset of a stage 1IIB HD [4,7], another in association with a relapse of HD 8 years after complete remission [5]. The fourth report describes a case of AIN in a patient with a history of stage IIA nodular sclerosing HD 4 years previously and no evidence of relapse [6].…”

Section: Discussionmentioning

confidence: 99%

“…Autoimmune neutropenia (AIN), however, has only been documented in 4 cases [4][5][6][7], We describe a patient in whom AIN occurred in asso ciation with recurrent HD after an episode of severe liver disease of unknown origin.…”

Section: Introductionmentioning

confidence: 99%

Immunoglobulin Therapy for Autoimmune Neutropenia in Hodgkin’s Disease

Schoengen¹,

Fembacher²,

Schulz³

1995

Acta Haematol

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Leukopenia, thrombocytopenia, and acute autoimmune hemolytic anemia associated with an unusual (type 2/4) Hodgkin's disease: Case report

et al. 1996

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plasma and blood transfusions, infections, autoimmune disorders, pregnancies, malignancies, and antibiotics [ 2 4 ] . We report the first case of an acquired factor V inhibitor in the setting of HIV infection.A 32-year-old man with HIV infection presented 10 days prior to admission with fever and weight loss for 2 months and diffuse lymphadenopathy. His hemoglobin (Hb) and platelet count were normal with a CD4 count of 220/pl (nl 410-1,840) and a CD8 count of 173O/pl (nl 270-870). On admission, he had a temperature of 100.5"F, and a Hb of 82 g/L (nl 120-150), platelet count of 7 X 10YL (nl ISWSO), reticulocyte % of3.9 (nlO.5-1.5), and LDH of 1,725 U/L (nl 2 9 7 4 1 1). Prothrombin time (PT), international normalized ratio (INR), and partial thromboplastin time (P'IT) were normal. A direct Coomb's antibody test was negative. The peripheral smear contained schistocytes and large platelets. His mental status, creatinine, and urinalysis were normal. A diagnosis of thrombotic thrombocytopenic purpura (TTP) was made and plasma exchange was begun. After initial improvement (Fig. I), the platelet count decreased. A bone marrow biopsy showed plasmacytosis and increased megakaryocytes. Elevated antiplatelet antibodies 2) and IgG 37.4% (nl2.1-12.1)] suggested a diagnosis of AIT. Plasma exchange was discontinued, and intravenous immunoglobulin (IVIG) was started. A cervical lymph node showed Kaposi sarcoma (KS), and an abdominal CT scan showed lymphadenopathy and splenomegaly. His thrombocytopenia was thought due to HIV-associated AIT and splenomegalic-KS, so he was treated with azidothymidine and vincristine plus interferon-a (IFF-a). A preoperative evaluation for a splenectomy revealed a PT of 21.9 sec (nl 11.1-12.9), INR of 4.3 (nl ratio I .O), and PTT of 61.2 sec (nl20.&33.5). These did not correct with vitamin K or fresh frozen plasma. His measured factor 11 activity was 64% (nl 83-126), factor V was 12% (nl 66152). factor VII was 59% (nl 66-156) and factor X was 75% (nl 65-142). A factor V mixing study was 9% (nl 85%) and factor V 50:5O mixed study was 28% (nl 47%), demonstrating the presence of a factor V inhibitor. Splenectomy was postponed, and on hospital day 17 his platelet count increased. He was discharged home with aplatelet count of 13 1 X 109/L. His coagulation indices normalized 1 month later while receiving weekly vincristine.During plasma exchange, he was exposed to 156 units of foreign factors that likely served as the antigenic stimulus to develop the inhibitor. Patients with coagulation factor inhibitors have been treated with FFP, cyclophosphamide, and prednisolone; platelets are used specifically for factor V inhibitors [ S ] . Specific therapy was not instituted because the patient was asymptomatic, the risk of further immunosuppression, and the possibility his inhibitor might disappear spontaneously. His asymptomatic course suggests that expectant management may be appropriate REFERENCES1 . Sande MA, Volberding PA (eds): The Medical Management of AIDS, 2nd ed., pp 33, Philadelphia, PA: W.B. Saunder...

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Autoimmune Neutropenia in Hodgkin's Disease

Cited by 13 publications

References 10 publications

Prospective Evaluation of the Chemiluminescence Test for the Detection of Granulocyte Antibodies: Comparison with the Granulocyte Immunofluorescence Test

Prospective Evaluation of the Chemiluminescence Test for the Detection of Granulocyte Antibodies: Comparison with the Granulocyte Immunofluorescence Test

Immunoglobulin Therapy for Autoimmune Neutropenia in Hodgkin’s Disease

Leukopenia, thrombocytopenia, and acute autoimmune hemolytic anemia associated with an unusual (type 2/4) Hodgkin's disease: Case report

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