Use of intravenous gamma globulin for the treatment of autoimmune neutropenia of childhood and autoimmune hemolytic anemia

Background: Human parvovirus B19 (HPV-B19) is the etiologic agent of erythema infectiosum, of transient aplastic crises in individuals with underlying chronic hemolytic disorders, and of chronic pure red cell aplasia in immunocompromised individuals.Case report. We describe a 14-year-old girl with long-standing Evans syndrome, who presented with severe anemia, reticulocytopenia and thromocytopenia. A bone marrow aspirate revealed severe erythroid hypoplasia along with presence of giant pronormoblasts, while serological studies and real-time PCR of whole blood were positive for acute parvovirus B19 infection. The patient was initially managed with corticosteroids, but both cytopenias resolved only after administration of intravenous gamma globulin 0.8g/kg.Conclusion: Acute parvovirus B19 infection should be suspected in patients with immunologic diseases, who present with reticulocytopenic hemolytic anemia and thrombocytopenia. In this setting, intravenous gamma globulin is effective for both cytopenias.

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High-Dose Intravenous Gamma Globulin for Autoimmune Neutropenia

New England Journal of Medicine ◽

10.1056/nejm198207223070420 ◽

1982 ◽

Vol 307 (4) ◽

pp. 253-253 ◽

Cited By ~ 42

Keyword(s):

Gamma Globulin ◽

High Dose ◽

Autoimmune Neutropenia ◽

Intravenous Gamma Globulin

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Autoimmune hemolytic anemia and autoimmune neutropenia in a child with erythroblastopenia of childhood (TEC) caused by human herpesvirus-6 (HHV-6)

Annals of Hematology ◽

10.1007/s00277-010-1095-x ◽

2010 ◽

Vol 90 (7) ◽

pp. 851-852 ◽

Cited By ~ 9

Author(s):

Hiroshi Yagasaki ◽

Maiko Kato ◽

Norio Shimizu ◽

Hiroyuki Shichino ◽

Motoaki Chin ◽

...

Keyword(s):

Hemolytic Anemia ◽

Autoimmune Hemolytic Anemia ◽

Human Herpesvirus ◽

Autoimmune Neutropenia ◽

Human Herpesvirus 6 ◽

Herpesvirus 6

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Chronic Lymphocytic Leukemia, Hypogammaglobulinemia and Autoimmune Hemolytic Anemia— An Experiment of Nature

Blood ◽

10.1182/blood.v15.5.748.748 ◽

1960 ◽

Vol 15 (5) ◽

pp. 748-757 ◽

Cited By ~ 18

Author(s):

ANTHONY V. PISCIOTTA ◽

LOUIS F. JERMAIN ◽

JEAN E. HINZ

Keyword(s):

Hemolytic Anemia ◽

Autoimmune Hemolytic Anemia ◽

Gamma Globulin ◽

Lymphocytic Leukemia ◽

Chronic Lymphatic Leukemia ◽

Lymphatic Leukemia ◽

Normal Human ◽

Human Gamma Globulin

Abstract 1. The case study is presented of a 75 year old man who had chronic lymphatic leukemia, autoimmune hemolytic anemia and hypogammaglobulinemia. The positive antiglobulin reaction with serum made from gamma globulin and the neutralization of the antiglobulin reaction with human gamma globulin demonstrated that this patient’s erythrocytes were coated with gamma globulin. 2. There was a normal survival time of I131-labeled normal human gamma globulin, suggesting defective synthesis of gamma globulin. Failure to demonstrate radioactivity on the patient’s erythrocytes when I131-labeled normal gamma globulin was given signified that normal human gamma globulin has no affinity in vivo for the patient’s red cells and that the erythrocyte-coating protein was derived from a source endogenous to the patient. 3. These relationships favor an immunologic mechanism in the development of an antiglobulin reaction in this patient.

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Cell Antigens and Cell Specialization. II. Demonstration of Some Red Cell Antigens of Human Normoblasts

Blood ◽

10.1182/blood.v24.5.522.522 ◽

1964 ◽

Vol 24 (5) ◽

pp. 522-530 ◽

Cited By ~ 5

Author(s):

JORGE J. YUNIS ◽

EDMOND J. YUNIS

Keyword(s):

Blood Group ◽

Hemolytic Anemia ◽

Autoimmune Hemolytic Anemia ◽

Gamma Globulin ◽

Red Cell ◽

Antigen Receptors ◽

Red Cell Antigens ◽

Cell Specialization

Abstract Evidence is presented for the presence of the antigens of nine blood group systems on normoblasts. The antigen receptors are detected on all stages of normoblasts. The in vivo demonstration of gamma globulin coating the reticulocytes and the normoblasts of a patient with erythroblastosis fetalis and the normoblasts of a patient with autoimmune hemolytic anemia are discussed in relationship to the pathogenesis of the anemia in both conditions.

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