A study of neutrophil function in a case of associated autoimmune neutropenia and thrombocytopenia treated with high doses of intravenous gammaglobulin (HDIGG).

In autoimmune disorders there is usually only one cell-type involved but occasionally there are more. The cell associated-IgG and -C3 in these disorders are sequestered normally in the spleen and removed by phagocytosis in the reticulum endothelial system (RES). Chronic idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease and normally presents only thrombocytopenia. Infrequently, neutropenia is associated. Recently high doses of intravenous gammaglobulin (HDIGG) have been used to block the cell destruction by RES in these diseases. The patient presented with ITP and associated neutropenia and was treated with HDIGG. We studied some neutrophil function, in relation to therapy (chemotaxis, random migration, latex phagocytosis, NBT reduction, superoxide generation), and performed some cytochemical stains (LAP and myeloperoxidase). We also determined the presence of antiplatelet and antineutrophil functions and resulted in an increase in the platelet and neutrophil count.