Abstract
High-dose immunoglobulin (HD-Ig) therapy was given to an infant with autoimmune neutropenia (AIN), and antineutrophil autoantibodies (ANAA). The patient's absolute neutrophil count in peripheral blood increased from 300/ mm3 to 3000–4000/mm3 7 days after treatment. Although the neutrophil count gradually decreased thereafter, transient increases were observed after each single booster infusion repeated at 3-week intervals. By continuing this treatment, clinical symptoms were markedly alleviated, and the patient's susceptibility to infection was reduced. The increase in neutrophils showed a positive correlation with the increase in serum IgG, and with the increase in the ratio of T helper/T suppressor cells. The neutrophil-bound IgG level and serum lysozyme level were decreased after HD-Ig therapy.
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Abbreviations
- HD-Ig:
-
high dose immunoglobulin
- AIn:
-
autoimmune neutropenia
- ANAA:
-
antineutrophil autoantibodies
- FACS:
-
fluorescence-activated cell sorter
- RFI:
-
relative fluorescence intensity
- NBIgG:
-
neutrophil-bound immunoglobulin G
References
Bussel JB, Higartner MW (1984) The use and mechanism of action of intravenous immunoglobulin in the treatment of immune haematologic disease. Br J Haematol 56:1–7
Bussel JB, Lalezari P, Hilgartner MW, Partin I, Fikrig S, O'Malley J, Barandun S (1983) Reversal of neutropenia with intravenous gammaglobulin in autoimmune neutropenia of infancy. Blood 62: 398–400
Furusawa S (1985) Autoimmune neutropenia. Acta Haematol Jpn 48:1753–1763
Imbach P, d'Apuzzi V, Hirt A, Ross E, Vest M, Barandun S, Morell A, Sohoni A, Wagner HP (1981) High-dose intravenous gammaglobulin for idiopathic thrombocytopenia purpura in childhood. Lancet 1:1228–1231
Harmon DC, Weitzman SA, Stossel TP (1984) The severity of immune neutropenia correlated with the maturation specificity of antineutrophil antibodies. Br J Haematol 58:209–215
Jiang AF, Lalezari P (1975) A microtechnique for detection of leukocyte agglutinins. J Immunol Methods 7:103–108
Kostmann R (1975) Infantile genetic aggranulocytosis. Acta Paediatr 45:1–78
Lalezari P, Jiang AF, Yegen L, Santorieneou M (1975) Chronic autoimmune neutropenia due to anti-NA2 antibody. N Engl J Med 293:744–747
Madyastha PR, Fudenberg HH, Glassman AB, Madyastha KR, Smith CL (1982) Autoimmune neutropenia in early infancy: a review. Ann Clin Lab Sci 12:356–367
Pollack S, Cunningham-Rundles C, Smithwick EM, Barandun S, Good RA (1982) High dose intravenous gammaglobulin for autoimmune neutropenia. N Engl J Med 307:253
Sabbc LJM, Claas FHJ, Langerak J, Clauso G, Smito LWA, de Konig JH, Schreuderx CH, Rood JJ (1982) Group specific autoimmune antibodies directed granulocytes as a cause of chronic benign neutropenia in infants. Acta Haematol 68:20–27
Saito K, Okuyama A, Hamaguchi H, Sakamaki H, Enokihara H, Furusawa S, Shishido H, Furuya N (1986) Detection of antineutrophil autoantibodies with immunofluorescence test using flow cytometry (FACS 420). Acta Haematol Jpn 49:733–738
Stahlie TD (1956) Chronic benign neutropenia in infancy and early childhood. J Pediatr 48:710–721
Thompson JS, Severson CD, Lavendar A, Forland M, Russe HP (1968) Assay of human leukoagglutinins by capillary migration. Transplantation 6:728–736
Verhengt FWA, Borne AEG, Noord-Bokhorst JC, Engelfried CP (1978) Autoimmune granulocytopenia: the detection of granulocyte autoantibodies with the immunofluorescence test. Br J Haematol 39:339–350
Zuelzer WW, Bajoghli M (1964) Chronic granulocytopenia in childhood. Blood 23:359–374
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Ikeda, H., Ozawa, T., Takahashi, H. et al. Immunological and haematological changes during high-dose immunoglobulin therapy in an infant with autoimmune neutropenia. Eur J Pediatr 146, 412–415 (1987). https://doi.org/10.1007/BF00444951
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DOI: https://doi.org/10.1007/BF00444951