G-CSF-induced decrease of the anti-granulocyte autoantibody levels in a patient with autoimmune granulocytopenia.
We present a case of an 81-year-old man with secondary autoimmune granulocytopenia in association with autoimmune thrombocytopenia. Treatment with granulocyte colony-stimulating factor (G-CSF) (5 micrograms/ kg/day s.c.) resulted in a rapid increase in the number of circulating granulocytes with a pronounced left shift. These changes were accompanied by up-regulation of the surface expression of Fc gamma RI (CD64) and Fc gamma RII (CD32) on the granulocytes. In addition, we noted a strong up-regulation of the Fc gamma RIII (CD16) and the activation markers CD11b and CD66b on the granulocytes. The increase in the number of circulating granulocytes was followed by a dramatic decrease in the level of cell-bound as well as circulating anti-granulocyte antibodies. It is hypothezised that the decrease in the level of cell-bound as well as circulating anti-granulocyte antibodies may be the result of an increased adsorption of the antibodies by the granulocytes.
Vlasveld
L T
LT
Department of Internal Medicine, Diaconessenhuis, Eindhoven, The Netherlands.
de Haas
M
M
Ermens
A A
AA
Porcelijn
L
L
van Marion-Kievit
J A
JA
von dem Borne
A E
AE
D000368:Aged; D000369:Aged, 80 and over; D000380:Agranulocytosis / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology / Q000627:therapeutic use*; D006098:Granulocytes / Q000276:immunology*; D006801:Humans; D008297:Male; D017452:Receptors, IgG / Q000096:biosynthesis / Q000235:genetics; D013921:Thrombocytopenia / Q000097:blood / Q000188:drug therapy / Q000276:immunology; D015854:Up-Regulation / Q000187:drug effects
D001323:Autoantibodies; D017452:Receptors, IgG; D016179:Granulocyte Colony-Stimulating Factor