Neutropenia and anaemia due to carbimazole-dependent antibodies.
Carbimazole-dependent antibodies to erythrocytes were detected in the sera of three anaemic patients who had been treated with carbimazole for hyperthyroidism. By the use of Rhnull-typed erythrocytes, we could show that some of these were directed against the proteins of the Rh complex. Carbimazole-dependent antibodies eluted from erythrocytes showed no binding to other blood cells. One patient also presented with neutropenia and mild thrombocytopenia. Additional carbimazole-dependent antibodies against the neutrophil-specific Fcgamma receptor IIIb (FcgammaRIIIb, CD16b) and the broadly expressed platelet endothelial cell adhesion molecule 1 (PECAM-1; CD31) were detected in this patient's serum. Surprisingly, the PECAM-1-reactive drug-dependent antibodies were also detectable in the sera of the other two patients with normal leucocyte and platelet counts. We assume that carbimazole can induce cell lineage-specific drug-dependent antibodies that cause cytopenia and also drug-dependent antibodies against the broadly expressed PECAM-1 molecule that may cause mild but not severe cytopenia.
Bux
J
J
Institute for Clinical Immunology and Transfusion Medicine, Justus-Liebig University, Giessen, Germany. juergen.bux@immunologie.med.uni-giessen.de
Ernst-Schlegel
M
M
Rothe
B
B
Panzer
C
C
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000139:chemically induced*; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D001792:Blood Platelets / Q000276:immunology; D002231:Carbimazole / Q000009:adverse effects* / Q000276:immunology; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced*; D009504:Neutrophils / Q000276:immunology; D013997:Time Factors
D013956:Antithyroid Agents; D001323:Autoantibodies; D002231:Carbimazole