Phagocytosis of Mature Granulocytes by Bone Marrow Macrophages in an Elderly Man with Adult-Onset Primary Autoimmune Neutropenia

Autor: Mitsutaka Nishimoto, Takahiko Nakane, Hideo Koh, Yasuhiro Nakashima, Ryosuke Yamamura, Hirohisa Nakamae, Masayuki Hino, Kensuke Ohta
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Hematology Reports, Vol 14, Iss 2, Pp 165-171 (2022)
Druh dokumentu: article
ISSN: 2038-8330
DOI: 10.3390/hematolrep14020024
Popis: Adult-onset primary autoimmune neutropenia (AIN) is an extremely rare but sometimes life-threatening disease. Its pathophysiology is still to be clarified. We describe a case with adult-onset primary AIN with phagocytosis of mature granulocytes by macrophages in bone marrow. A 77-year-old male was referred to our hospital with severe neutropenia. Based on the normal cellular bone marrow without morphological dysplasia and the positivity of anti-neutrophil antibodies in the serum, adult-onset primary AIN was diagnosed. After five years from the initiation of granulocyte colony-stimulating-factor therapy, neutropenia had progressed. At that time, the second bone marrow examination revealed segmented neutrophils phagocytosed by macrophages. Continuous low dose prednisolone succeeded to increase the neutrophil count. An impressive morphological feature of AIN indicated the destruction of mature granulocytes in bone marrow by antibody-dependent cellular phagocytosis mediated by granulocyte-specific antibodies. More cases should be accumulated to elucidate the precise mechanism and establish the optimal therapy.
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