Cartron J, Fior R, Boué F, Tertian G, Gane P, Cartron J P
Centre de Transfusion Sanguine et Laboratoire d'Hématologie, Hôpital de Bicêtre, Kremlin-Bicêtre, France.
Hematol Cell Ther. 1996 Apr;38(2):225-30. doi: 10.1007/s00282-996-0225-3.
A sixty-year old female was referred to the Internal Medicine Department for the treatment of a diffuse high-grade non Hodgkin's lymphoma. She presented episodes of fever in context of neutropenia (neutrophils 0.35 x 10(9)/1 from 1.6 x 10(9)/1 white blood cells). Hemoglobin level was 8.2 g/dl and platelets 132 x 10(12)/1. A monoclonal IgM-Kappa protein (48 g/l) was detected in her serum. A direct antiglobulin test on the red cells proved positive with anti-C3d but not with anti-IgG antiglobulin, due to the presence of an IgM cold antibody with a serological anti-i specificity. The IgM antibody was found on the patient's neutrophils as well as in her serum. The antibody recognized all neutrophils tested in conventional serological tests whether the neutrophil phenotypes in systems NA, NB, and 5. It was demonstrated that it recognized the i antigen expressed on the neutrophils. These results suggest that a cold agglutinin anti-i might be responsible for neutropenia in some patients.
一名60岁女性因弥漫性高级别非霍奇金淋巴瘤被转诊至内科。她在中性粒细胞减少（中性粒细胞从白细胞计数1.6×10⁹/L降至0.35×10⁹/L）的情况下出现发热症状。血红蛋白水平为8.2g/dl，血小板计数为132×10¹²/L。在她的血清中检测到单克隆IgM-κ蛋白（48g/L）。对红细胞进行的直接抗球蛋白试验显示，由于存在具有血清学抗-i特异性的IgM冷抗体，抗C3d呈阳性，但抗IgG抗球蛋白呈阴性。在患者的中性粒细胞以及血清中均发现了IgM抗体。该抗体在常规血清学试验中识别所有测试的中性粒细胞，无论其在NA、NB和5系统中的中性粒细胞表型如何。结果表明，它识别在中性粒细胞上表达的i抗原。这些结果提示，冷凝集素抗-i可能是某些患者中性粒细胞减少的原因。
