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International Journal of Hematology

, Volume 73, Issue 3, pp 346–350 | Cite as

Autoimmune Neutropenia With Cyclic Oscillation of Neutrophil Count After Steroid Administration

  • Nobuhisa Hirase
  • Yasunobu Abe
  • Koichiro Muta
  • Hideki Ishikura
  • Tsukuru Umemura
  • Hajime Nawata
  • Junji Nishimura
Case Report

Abstract

A 16-year-old female patient was evaluated for pancytopenia. She had a white blood cell count of 1.6 x 109/L with 0.02 neutrophils and a platelet count of 19 x109/L. In the bone marrow, mature granulocytes were markedly decreased in number, but no atypical cells were present. Antineutrophil antibody was demonstrated by flow cytometry, and the level of platelet-associated immunoglobulin G was increased. A diagnosis of autoimmune neutropenia and thrombocytopenia was made. Interestingly, neutrophil and platelet counts fluctuated cyclically after the initiation of prednisolone therapy. The neutrophil count fluctuated between 0.1 x 109/L and 7 x 109/L, and the platelet count fluctuated between 19 x 109/L and 175 x 109/L, in 4-week cycles. Following splenectomy, neutrophil and platelet counts normalized. We believe the immune mechanism of recurrent neutropenia in this patient differs from that in other patients with cyclic neutropenia reported with stem cell disorders.

Key words

Autoimmune neutropenia Cyclic neutropenia Antineutrophil antibody Prednisolone Splenectomy 

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Copyright information

© The Japanese Society of Hematology 2001

Authors and Affiliations

  • Nobuhisa Hirase
    • 1
  • Yasunobu Abe
    • 1
  • Koichiro Muta
    • 1
  • Hideki Ishikura
    • 2
  • Tsukuru Umemura
    • 3
  • Hajime Nawata
    • 1
  • Junji Nishimura
    • 4
  1. 1.Department of Medicine and Bioregulatory ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuoka
  2. 2.Department of Internal MedicineAso-Iizuka HospitalFukuokaJapan
  3. 3.Department of Medical Technology, School of Health SciencesKyushu UniversityFukuokaJapan
  4. 4.Department of Clinical ImmunologyMedical Institute of Bioregulation, Kyushu UniversityOitaJapan

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