An Infantile Case of Autoimmune Neutropenia with Thrombocytopenia

• Published in: The Japanese Journal of Pediatric Hematology Vol. 4; no. 2; pp. 187 - 191
• Main Authors: SUGITA, Kenichi, OZAWA, Takebumi, OWADA, Yoko, EGUCHI, Mitsuoki, FURUKAWA, Toshiharu
• Format: Journal Article
• Language: Japanese
• Published: THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY 30.06.1990
• ISSN: 0913-8706; 1884-4723
• DOI: 10.11412/jjph1987.4.187

An infantile case of combined autoimmune neutropenia and thrombocytopenia is reported. A 5-month-old boy was referred to our department because of petechiae over the whole body. Hematological examination showed a white cell count of 6, 000 cells/μl with severe neutropenia and thrombocytopenia (2, 000 platelets/ μl). Bone marrow aspiration revealed normocellularity (16.9 x 104 cells/ μl) with a normal megakaryocyte count (90 cells/μl). However, platelets adhering to megakaryocytes and percentage of segmented neutrophils were decreased in May-Giemsa stain of bone marrow specimens. An increase of toxic granules in the cytoplasm was also observed. Immunological examination showed positive findings for platelet-associated IgG and neutrophil-binding IgG. A diagnosis of autoimmune neutropenia with thrombocytopenia was made, and therapy with prednisolone and intact-typed γ globulin was started. The platelet count immediately improved, but the neutrophil count did not increase until 20 days. He was discharged from the hospital after 3 months of treatment. However, bleeding tendency and recurrent infection were often seen.