Wang Justin Dejia, Brazel Danielle, Nagler Emily
Department of Medicine, Scripps Mercy Hospital, San Diego, CA 92103, USA.
Department of Hematology/Oncology, Scripps Clinic/Scripps Green Hospital, La Jolla, CA 92037, USA.
J Med Cases. 2024 Dec;15(12):396-400. doi: 10.14740/jmc4306. Epub 2024 Nov 11.
Autoimmune neutropenia (AIN) refers to the immune-mediated destruction of neutrophils. It is a rare condition with an estimated prevalence of less than 1 case per 100,000 per year. Typical treatment involves supportive care with granulocyte colony-stimulating factor (G-CSF) and management of secondary infections with antibiotics. Other therapies targeted at the immune system such as steroids, intravenous immunoglobulin (IVIG), and rituximab have not been thoroughly evaluated, but recently rituximab has shown promising results in one case series. We present a 76-year-old man with the diagnosis of antineutrophil antibody-negative AIN and concurrent immune thrombocytopenic purpura (ITP), whose AIN was treated initially with G-CSF which had a short-lived effect, then treated with rituximab which induced a lasting remission. We then review this case in context of other cases described in the literature, given the paucity of available publications.
自身免疫性中性粒细胞减少症(AIN)是指免疫介导的中性粒细胞破坏。它是一种罕见疾病,估计每年患病率低于十万分之一。典型治疗包括使用粒细胞集落刺激因子(G-CSF)进行支持性治疗以及使用抗生素治疗继发感染。其他针对免疫系统的疗法,如类固醇、静脉注射免疫球蛋白(IVIG)和利妥昔单抗,尚未得到充分评估,但最近利妥昔单抗在一个病例系列中显示出了有前景的结果。我们报告一名76岁男性,诊断为抗中性粒细胞抗体阴性的AIN并并发免疫性血小板减少性紫癜(ITP),其AIN最初用G-CSF治疗,效果短暂,随后用利妥昔单抗治疗,诱导了持久缓解。鉴于现有文献数量稀少,我们结合文献中描述的其他病例对该病例进行了回顾。