Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
A Case of Evans' Syndrome Following Idiopathic Thrombocytopenic Purpura
A Special Reference to Antibody-Dependent Cell-Mediated Cytotoxicity by Peripheral Blood Leukocytes as a Mechanism of Hemolysis
Masatoshi TAKAYA, Yukinobu ICHIKAWA, Shigeru ARIMORI
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1980 Volume 21 Issue 12 Pages 1916-1922

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Abstract
A 21-year-old male patient was admitted because of acute onset of generalized purpura and thrombocytopenia (0.2×104/cmm) in Dec., 1977, and treated with prednisolone (PSL) under the diagnosis of idiopathic thrombocytopenic purpura. In Sept., 1979, he noticed jaundice and general malaise. Marked anemia and mild splenomegaly were demonstrated. Examinations of peripheral blood showed normocytic anemia (Hb 5.2 g/dl), leukocytosis (10,700/cmm), thrombocytopenia (6.1×104/cmm), and reticnlocytosis (12.2%). Hemolytic anemia was confirmed by other laboratory data, such as indirect bilirubin, serum LDH, serum iron, and myelogram. Both direct and indirect antiglobulin test were positive, and anti-erythrocyte antibody in his serum was confirmed as IgG. Treatment with large dosage of PSL (100 mg/day) was started. Anemia and then thrombocytopenia were gradually improved.
Antibody-dependent cell-mediated cytotoxicity (ADCC) of human peripheral leukocytes (PBL) was investigated by using 51Cr-labelled human erythrocytes sensitized with the patients serum. It was concluded that ADCC of PBL in this case was not participated in the mechanism of hemolysis, because neither cytotoxic nor phagocytic activity of PBL was demonstrated against target erythrocytes.
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© 1980 The Japanese Society of Clinical Hematology
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