|
1
|
Nishimoto M, Nakane T, Koh H, Nakashima Y, Yamamura R, Nakamae H, Hino M, Ohta K. Phagocytosis of Mature Granulocytes by Bone Marrow Macrophages in an Elderly Man with Adult-Onset Primary Autoimmune Neutropenia. Hematol Rep 2022; 14:165-171. [PMID: 35735735 PMCID: PMC9223026 DOI: 10.3390/hematolrep14020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/31/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Adult-onset primary autoimmune neutropenia (AIN) is an extremely rare but sometimes life-threatening disease. Its pathophysiology is still to be clarified. We describe a case with adult-onset primary AIN with phagocytosis of mature granulocytes by macrophages in bone marrow. A 77-year-old male was referred to our hospital with severe neutropenia. Based on the normal cellular bone marrow without morphological dysplasia and the positivity of anti-neutrophil antibodies in the serum, adult-onset primary AIN was diagnosed. After five years from the initiation of granulocyte colony-stimulating-factor therapy, neutropenia had progressed. At that time, the second bone marrow examination revealed segmented neutrophils phagocytosed by macrophages. Continuous low dose prednisolone succeeded to increase the neutrophil count. An impressive morphological feature of AIN indicated the destruction of mature granulocytes in bone marrow by antibody-dependent cellular phagocytosis mediated by granulocyte-specific antibodies. More cases should be accumulated to elucidate the precise mechanism and establish the optimal therapy.
Collapse
Affiliation(s)
- Mitsutaka Nishimoto
- Hematology Ohta Clinic, Shinsaibashi, Osaka 5420081, Japan; (T.N.); (R.Y.); (K.O.)
- Hematology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 5458585, Japan; (H.K.); (Y.N.); (H.N.); (M.H.)
- Correspondence: ; Tel.: +81-6-6645-3881
| | - Takahiko Nakane
- Hematology Ohta Clinic, Shinsaibashi, Osaka 5420081, Japan; (T.N.); (R.Y.); (K.O.)
| | - Hideo Koh
- Hematology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 5458585, Japan; (H.K.); (Y.N.); (H.N.); (M.H.)
| | - Yasuhiro Nakashima
- Hematology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 5458585, Japan; (H.K.); (Y.N.); (H.N.); (M.H.)
| | - Ryosuke Yamamura
- Hematology Ohta Clinic, Shinsaibashi, Osaka 5420081, Japan; (T.N.); (R.Y.); (K.O.)
| | - Hirohisa Nakamae
- Hematology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 5458585, Japan; (H.K.); (Y.N.); (H.N.); (M.H.)
| | - Masayuki Hino
- Hematology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 5458585, Japan; (H.K.); (Y.N.); (H.N.); (M.H.)
| | - Kensuke Ohta
- Hematology Ohta Clinic, Shinsaibashi, Osaka 5420081, Japan; (T.N.); (R.Y.); (K.O.)
| |
Collapse
|