Autoimmune thrombocytopenia following peripheral blood stem cell autografting.
A 22-year-old woman diagnosed as AML (M3) received myeloablative chemotherapy followed by autologous peripheral stem cell transplantation (PBSCT). Rapid hematopoietic reconstitution occurred. By day 10, the neutrophil count was > 0.5 x 10(9)/l and the platelet count > 50 x 10(9)/l. The platelet count was 145 x 10(9)/l on day 20. Purpura developed on the anterior chest and legs on day 50, at which time the platelet count fell to 17 x 10(9)/l. The BM was hypocellular with an increase in megakaryocytes. Platelet-associated IgG (PAIgG) was 88.1 ng/10(7) platelets (normal range 9-25 ng/10(7)); a diagnosis of idiopathic thrombocytopenic purpura (ITP) was made. Prednisolone administration led to an increase in the platelet count and a decrease in PAIgG. Analysis of lymphocyte subsets revealed an increased number of CD3+ gamma/delta T cells. It is postulated that the thrombocytopenia in this case was due to an autoimmune mechanism such as ITP.
Ashihara
E
E
Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan.
Shimazaki
C
C
Hirata
T
T
Okawa
K
K
Oku
N
N
Goto
H
H
Inaba
T
T
Fujita
N
N
Nakagawa
M
M
D000328:Adult; D016824:Antigens, Human Platelet / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology; D001327:Autoimmune Diseases / Q000209:etiology* / Q000276:immunology; D016913:Blood Component Transfusion / Q000009:adverse effects*; D001804:Blood Transfusion, Autologous / Q000009:adverse effects*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications / Q000628:therapy*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000209:etiology* / Q000276:immunology; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000032:analysis; D016176:T-Lymphocyte Subsets
D016824:Antigens, Human Platelet; D001323:Autoantibodies; D007074:Immunoglobulin G; D016692:Receptors, Antigen, T-Cell, gamma-delta