Two Cases of Autoimmune Neutropenia Complicated with Other Lineages of Autoimmune Cytopenia, Successfully Treated with Prednisolone

Intern Med. 2021 Apr 15;60(8):1271-1277. doi: 10.2169/internalmedicine.6032-20. Epub 2020 Nov 9.

Abstract

Though adult-onset primary autoimmune pancytopenia (AIP) rarely follows a self-limited course, a standard treatment strategy has not yet been established. We herein report two cases, each involving primary autoimmune neutropenia complicated with autoimmune thrombocytopenia or Evans syndrome. They were refractory to granulocyte-colony stimulating factor, but all lineages of cytopenia promptly recovered with prednisolone (PSL). In case 1, PSL was tapered and discontinued six months after its initiation without AIP relapse. In case 2, PSL has been tapered for five months without relapse. To establish an optimal treatment strategy for AIP, it is necessary to accumulate more cases.

Keywords: antineutrophil antibody; autoimmune neutropenia; autoimmune pancytopenia; prednisolone.

MeSH terms

  • Adult
  • Anemia, Hemolytic, Autoimmune* / complications
  • Anemia, Hemolytic, Autoimmune* / diagnosis
  • Anemia, Hemolytic, Autoimmune* / drug therapy
  • Autoimmune Diseases* / complications
  • Autoimmune Diseases* / diagnosis
  • Autoimmune Diseases* / drug therapy
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Humans
  • Neutropenia* / drug therapy
  • Prednisolone / therapeutic use
  • Thrombocytopenia* / complications
  • Thrombocytopenia* / drug therapy

Substances

  • Granulocyte Colony-Stimulating Factor
  • Prednisolone