International Journal of Laboratory Hematology 2010-02-01

Anti-polymorphonuclear neutrophil antibodies in patients with leukopenia or neutropenia.

N E Riera, M Rosso Saltó, V Galán, K Canalejo, M Khoury, M Aixalá, G L Kantor, M Vermeulen, R Bengió, M M E De Bracco

Index: Int. J. Lab. Hematol. 32(1 Pt 1) , e96-105, (2010)

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Abstract

Immune humoral neutropenia (Np) could be the consequence of anti-polymorphonuclear neutrophil (PMN) antibodies, circulating immune complexes (CIC) and/or antibodies against myeloid precursors. Granulocyte immunofluorescence test (GIFT) and a leukoagglutination technique (LAGT) assays are recommended for its diagnosis.Fifty adult patients with secondary Np were screened for anti-PMN. GIFT by flow cytometry from viable PMN and LAGT were employed. In addition, CIC levels, low expression of CD16(b) (CD16 (b)(low)), PMN phenotype and sera tumor necrosis factor-alpha (TNF-alpha) were also evaluated.Direct IgG-PMN binding (dir-GIFT) was positive in 16% of the patients. Antibodies against autologous PMN were detected in 32% of the samples by indirect (ind)-GIFT and demonstrated in 70% of the sera by both ind-GIFT and/or LAGT. Predominance of human neutrophil alloantigen (HNA)-1b and HNA-2 expression was confirmed. CD16(b)(low) was detected in 16% of the patient's PMN and TNF-alpha in 68% of sera patients.Our results suggest that diagnosis of immune Np in the laboratory may be improved by focusing on patient's PMN together with the assessment of cellular markers.