Harada Saori, Yamazaki Sho, Nakamura Fumihiko, Morita Ken, Yoshimi Akihide, Shinozaki-Ushiku Aya, Fukayama Masashi, Kurokawa Mineo
Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Department of Pathology, Graduate School of Medicine, The University of Tokyo 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Int J Clin Exp Pathol. 2014 Aug 15;7(9):6386-90. eCollection 2014.
Autoimmune neutropenia (AIN), resulting from granulocyte-specific autoantibodies, is much less frequent than other autoimmune hematologic disorders including autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). These autoimmune disorders may precede, synchronize, or follow collagen disorders, viral infections, and lymphoid neoplasms. Herein we present the first case of AIN in association with Helicobacter pylori-negative mucosa-associated lymphoid tissue (MALT) lymphoma with nodal dissemination. In our case, AIN, accompanied by ITP, occurred prior to the clinical manifestation of lymphoma. AIN and ITP were well managed afterwards, but they relapsed in accordance with the recurrence of lymphoma. The administration of prednisolone at 0.5 mg/kg daily alleviated the cytopenias within a week. In general, combination chemotherapy is performed for the treatment of lymphoma-associated autoimmune hematologic disorders and indeed seems to be effective. Our case indicates that corticosteroid monotherapy may be effective for lymphoma-associated AIN especially when AIN precedes the onset of lymphoma.
自身免疫性中性粒细胞减少症(AIN)由粒细胞特异性自身抗体引起,其发病率远低于其他自身免疫性血液系统疾病,如自身免疫性溶血性贫血(AIHA)和免疫性血小板减少症(ITP)。这些自身免疫性疾病可能先于、同步或继发于胶原病、病毒感染和淋巴瘤。在此,我们报告首例与幽门螺杆菌阴性的黏膜相关淋巴组织(MALT)淋巴瘤伴淋巴结播散相关的AIN病例。在我们的病例中,AIN伴发ITP,发生在淋巴瘤临床表现之前。AIN和ITP随后得到了良好控制,但随着淋巴瘤的复发而复发。每日给予0.5mg/kg泼尼松龙可在一周内缓解血细胞减少症。一般来说,联合化疗用于治疗淋巴瘤相关的自身免疫性血液系统疾病,且似乎确实有效。我们的病例表明,皮质类固醇单药治疗可能对淋巴瘤相关的AIN有效,尤其是当AIN先于淋巴瘤发病时。