title: [Reticulocytopenia and neutropenia in 3 patients with idiopathic autoimmune hemolytic anemia].
abstract: Retyculocytopenia and neutropenia or both abnormalities are very infrequent findings during the evolution of patients with acquired autoimmune hemolytic anemia (AIHA). In this paper we describe the clinical cases of three patients with AIHA in whom six different periods of reticulocytopenia were identified; the first two patients also had neutropenia. At the moment of the diagnosis of the cytopenias, the patients did not have a systemic disease, a viral infection or received immunosuppression able to produce them. In every patient the bone marrow cellularity was increased mostly at the expense of normal and macroerythroblasts, containing significant amounts of the other hematopoietic cells. After the diagnosis of AIHA, the patients received supplementary treatment with folic acid which did not produce a remission. The remissions were related to steroids: the neutrophil counts increased importantly one to ten days after starting the steroid administration, whereas reticulocytes reappeared more slowly from 7 to 30 days post-initiation. In patients with AIHA the occurrence of reticulocytopenia and neutropenia have been related to several causes. The favorable responses to steroids in our cases suggests a relationship of steroid with the immunological changes in AHA. It should be pointed out that it is necessary to prolong the followup as done in our three cases. Although these cytopenias may be independent from the hemolytic anemia, we feel our cases suggest that they could be manifestations of a pathologic state not yet characterized.
authors.affiliation: Servicio de Hematología, Hospital de Especialidades del Centro MédicoNacional Siglo XXI, México, D.F.
authors.forename: M R
authors.initials: MR
authors.lastname: Morales-Polanco
authors.forename: L J
authors.initials: LJ
authors.lastname: Casanova-Cardiel
authors.forename: E
authors.initials: E
authors.lastname: Fuentes
authors.forename: J
authors.initials: J
authors.lastname: Pizzuto-Chávez
mesh_terms: D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000188:drug therapy / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D012156:Reticulocytes; D012189:Retrospective Studies
chemical_list: D011241:Prednisone
vernacular_title: Reticulocitopenia y neutropenia en tres pacientes con anemia hemolítica autoimune idiopática.