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International Journal of Hematology

, Volume 75, Issue 5, pp 484–488 | Cite as

Abnormal NK Cell Lymphocytosis Detected after Splenectomy: Association with Repeated Infections, Relapsing Neutropenia, and Persistent Polyclonal B-Cell Proliferation

  • Elisa Granjo
  • Margarida Lima
  • Manuela Fraga
  • Filipe Santos
  • Conceição Magalhães
  • Maria Luís Queirós
  • Ilidia Moreira
  • Sandra Rocha
  • Alice Santos Silva
  • Irene Rebelo
  • Alexandre Quintanilha
  • Maria Letícia Ribeiro
  • Jorge Candeias
  • Alberto Orfão
Case Report

Abstract

We report the case of a boy with hereditary spherocytosis who presented with mild microcytic hypochromic anemia and recurrent leg ulcers that had been present since childhood. Chronic natural killer (NK) cell and B-cell lymphocytosis was detected 1 year after therapeutic splenectomy during investigation of recurrent episodes of neutropenia and persistent lymphocytosis. NK cells proved to be abnormal at immunophenotyping studies, and B-cells were polyclonal and displayed a normal immunophenotype. Genotypic analysis of T-cell receptor (TCR)-β and TCR-γ genes showed a germ-line pattern. The clinical course of this patient was characterized by multiple pulmonary infections and amygdalitis. We discuss the potential roles of persistent immune stimulation due to chronic hemolysis and severe leg ulcers and of splenectomy in the origin of NK cell lymphocytosis and the relationship between NK cells and recurrent infections, relapsing neutropenia, and polyclonal B-cell response.Int J Hematol. 2002;75:484–488.

Key words

NK cells Neutropenia B-cells Spherocytosis Splenectomy 

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Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Elisa Granjo
    • 1
  • Margarida Lima
    • 2
  • Manuela Fraga
    • 3
  • Filipe Santos
    • 4
  • Conceição Magalhães
    • 4
  • Maria Luís Queirós
    • 2
  • Ilidia Moreira
    • 1
  • Sandra Rocha
    • 1
  • Alice Santos Silva
    • 5
  • Irene Rebelo
    • 5
  • Alexandre Quintanilha
    • 6
    • 7
  • Maria Letícia Ribeiro
    • 8
  • Jorge Candeias
    • 4
  • Alberto Orfão
    • 9
  1. 1.Department of HematologyHospital S. JoãoPortugal
  2. 2.Service of Hematology, Unit of CytometryHospital S. AntónioPortugal
  3. 3.Department of ImmunotherapyHospital S. JoãoPortugal
  4. 4.Department of ImmunologyHospital S. JoãoPortugal
  5. 5.Faculdade de FarmáciaPortugal
  6. 6.Instituto de Ciências Biomédicas Abel SalazarPortugal
  7. 7.Instituto de Biologia Celular e MolecularPortoPortugal
  8. 8.Centro Hospitalar de CoimbraCoimbraPortugal
  9. 9.Service of CytometryHospital Universitario de SalamancaSalamancaSpain

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