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The influence of disease activity on the number of blood cells of multiple sclerosis patients

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Summary

The influence of disease activity on blood cell counts was studied in over 100 multiple sclerosis patients examined at regular intervals of 4–8 weeks over an 18-month period. T-lymphocytes were assessed by the cytochemical α-naphthyl-acetate-esterase (ANAE) stain in addition to conventional differentials. In all patients as a group as well as in individual patients studied sequentially, an exacerbation was marked by a striking reduction in both the relative and absolute numbers of ANAE-positive cells. Simultaneously, a strong increase in granulocytes and a slight augmentation of ANAE-negative cells occurred. Similar changes related to disease activity in leucocytes and lymphocytes were also detected in conventional blood smears. Fluctuations in the number of blood cells with disease activity persisted under therapy with corticosteroids and to a lesser degree also with azathioprine.

Zusammenfassung

Bei über 100 Multiple-Sklerose-Kranken wurde im Verlauf von eineinhalb Jahren in möglichst regelmäßigen Abständen von 4–8 Wochen untersucht, ob und inwieweit die Krankheitsaktivität das Blutbild beeinflußt. Dabei wurde speziell das Verhalten der T-Lymphozyten mit Hilfe der α-Naphthylacetatesterase-Färbung studiert. Kranke im Schub hatten eine deutliche und Kranke im Stadium der Progression eine leicht verminderte Anzahl von T-Lymphozyten, und zwar nicht nur relativ, sondern auch absolut. Umgekehrt war im Krankheitsschub die absolute Anzahl der Granulozyten stark, die der ANAE-negativen Lymphozyten gering vermehrt. Auch im Krankheitsverlauf schwankte die Zahl der genannten Zellen in Abhängigkeit von der Krankheitsaktivität. Die Zahl der T-Lymphozyten nahm deutlich ab, wenn sich ein Schub einstellte, auch dann, wenn er sich einem schon progredienten Verlauf aufpfropfte. Zugleich nahm die Zahl der Granulozyten und ANAE-negativen Lymphozyten zu. Im konventionellen Blutbild spiegelten sich diese Veränderungen in der Leukozytenzahl und der relativen Anzahl der Lymphozyten ebenfalls deutlich wieder. Diese von der Aktivität der Krankheit abhängige Fluktuation der Blutbestandteile wurde nur zum Teil hervorgerufen durch die Therapie mit Prednison und/oder Azathioprin. Kortikosteroide und Azathioprin hatten gegensinnige Wirkungen auf die Anzahl der Granulozyten. Bei Azathioprinbehandelten waren die Unterschiede in der Anzahl der Blutzellen zwischen Krankheitsschub und Intervall am geringsten.

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Authors and Affiliations

  1. Division of Neurology, Hannover Medical School, Konstanty-Gutschow-Straße, D-3000, Hannover, Federal Republic of Germany

    U. Patzold, U. Wurster & K. Mardt

  2. Division of Biometrics, Hannover Medical School, Konstanty-Gutschow-Straße, D-3000, Hannover, Federal Republic of Germany

    M. Schiemann

Authors
  1. U. Patzold
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  2. U. Wurster
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  3. K. Mardt
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  4. M. Schiemann
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This study was supported by the Hertie Foundation

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Patzold, U., Wurster, U., Mardt, K. et al. The influence of disease activity on the number of blood cells of multiple sclerosis patients. J Neurol 231, 26–33 (1984). https://doi.org/10.1007/BF00313648

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  • DOI: https://doi.org/10.1007/BF00313648

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