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Immune response in patients with autoimmune thrombocytopenia and autoimmune haemolytic anaemia receiving azathioprine

Immunreaktion nach Azathioprinbehandlung bei Autoimmunthrombozytopenie und Autoimmunhämolytischer Anämie

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Summary

Despite the clinical improvement in 4 patients with refractory autoimmune thrombocytopenia and autoimmune haemolytic anaemia treated with azathioprine, no decline in the antibody titre was observed whereas the synthesis of immunoglobulins was depressed. In experimental animals, the inhibitory effect of splenectomy and azathioprine on the immunoglobulin synthesis was confirmed. The missing correlation between the clinical improvement and persisting antibody levels is pointed out.

Zusammenfassung

In einer mehrjährigen Verlaufsstudie werden 2 Patienten mit einer Autoimmun-Thrombozytopenie und 2 Patienten mit einer autoimmunhämolytischen Anämie vom Wärme- bzw. Kälteantikörpertyp beschrieben, die nach der Splenektomie und langfristiger Steroidbehandlung keine Dauerremission zeigten. Eine langfristige klinische Besserung wurde durch Azathioprin erreicht. Während der immunsuppressiven Therapie wurden die Titer der Serumimmunglobuline gesenkt. Hierzu korrelierend konnte im Tierversuch eine vergleichbare Abnahme der Serumimmunglobuline nach der Splenektomie bzw. nach der Azathioprinbehandlung beobachtet werden.

Im Gegensatz zum klinischen Erfolg der immunsuppressiven Therapie blieben die spezifischen Immunreaktionen der Patienten unbeeinflußt.

Im Hinblick auf einen Auslaßversuch von Azathioprin, der zu einer schweren hämorrhagischen Diathese führte, wird hervorgehoben, daß der autoimmunologische Prozeß dieser Erkrankungen nicht unterbrochen wird solange die Autoantiköpertiter in vitro nachzuweisen sind.

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Authors and Affiliations

  1. Department of Medicine, University of Marburg, Germany

    K. M. Goebel, F. D. Goebel, W. D. Gassel & K. Mueller

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  1. K. M. Goebel
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  2. F. D. Goebel
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  3. W. D. Gassel
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  4. K. Mueller
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Additional information

Presented in preliminary form at the Ninth International Congress of Biochemistry. Stockholm, July 1973.

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Goebel, K.M., Goebel, F.D., Gassel, W.D. et al. Immune response in patients with autoimmune thrombocytopenia and autoimmune haemolytic anaemia receiving azathioprine. Klin Wochenschr 52, 916–920 (1974). https://doi.org/10.1007/BF01468937

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