Abstract:
:BACKGROUND: Antineutrophil cytoplasmic antibodies (ANCA) can be associated with various disorders. However, their association with neutropenia has never been reported. METHODS: Nine patients with chronic unexplained neutropenia and ANCA were studied. Clinical charts were extensively analyzed and all patients underwent hematological and immunological investigations. RESULTS: All patients (6 women and 3 men) were Caucasian and had a mean age of 49 years (range 16-67 years). All presented with a neutropenia below 1.5x10(9)/L for more than 6 months. The neutropenia was <0.5x10(9)/L in six cases and moderate in three. There was no evidence of toxic- or drug-related neutropenia or of a hematological malignancy. Autoimmune anemia and/or thrombocytopenia were present in five patients. ANCA, with various specificities, were present in all patients. ANCA were associated with various other autoantibodies in eight patients, including antisurface-neutrophil antibodies in three cases. Four of the six patients with severe neutropenia experienced infections. Five patients were treated with hematopoietic growth factors, steroids, intravenous immunoglobulins, splenectomy, methotrexate and/or cyclophosphamide, allowing the neutrophil count to be restored transiently or permanently. CONCLUSIONS: A subset of patients with neutropenia of possible autoimmune origin may develop ANCA. Their detection would provide strong evidence of an autoimmune mechanism. Neutropenia should be added to the list of ANCA-associated diseases.
journal_name
Eur J Intern Medjournal_title
European journal of internal medicineauthors
Coppo P,Ghez D,Fuentes V,Bengoufa D,Oksenhendler E,Tribout B,Clauvel JP,Lassoued Kdoi
10.1016/j.ejim.2004.08.009subject
Has Abstractpub_date
2004-11-01 00:00:00pages
451-459issue
7eissn
0953-6205issn
1879-0828pii
S0953-6205(04)00197-9journal_volume
15pub_type
杂志文章abstract::The evolution of strategies for the use of spironolactone and its analogue, eplerenone, has, over the years, encompassed favourable modification of the natural history of symptomatic heart failure in subjects with subnormal left ventricular ejection fraction (LVEF), and mitigation of the risk of new-onset atrial fibri...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
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journal_title:European journal of internal medicine
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journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
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journal_title:European journal of internal medicine
pub_type: 杂志文章
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journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2004.05.006
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journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2005.10.004
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pub_type: 杂志文章
doi:10.1016/j.ejim.2011.11.005
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doi:10.1016/j.ejim.2011.10.006
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journal_title:European journal of internal medicine
pub_type: 杂志文章
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journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/s0953-6205(01)00170-4
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journal_title:European journal of internal medicine
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pub_type: 临床试验,杂志文章
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journal_title:European journal of internal medicine
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journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
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