Abstract
A 79-year-old man with chronic bronchitis was hospitalized because of anemia and leukopenia. Peripheral blood smears revealed elliptocytes in 80% of red blood cells. Chemotactic activity as measured by the modification of Boyden's method was completely deficient; Chemotactic activity was O (normal, 220∼578), while in vivo neutrophil migration detected by skin window method was normal. Random motility was slightly decreased to 34μ (normal, 38∼55μ). Phagocytosis and NBT test showed a mild decrease. Serum chemotactic factor level was normal. In addition, serum IgE was elevated to 1739 IU/L (normal, less than 400). The number of B lymphocytes detected as EAC-rosette forming lymphocytes and surface-Ig bearing lymphocytes were markedly decreased to 1.3% (normal, 8.7∼17.2) and 2.9% (normal, 13.1∼29.5), respectively.
This is a very rare case in terms of elliptocytosis associated with defective neutrophil chemotaxis occurring at old age and B lymphocytopenia. It remains to be studied whether or not common defect in blood cell membranes is responsible for the deformity of red blood cells (elliptocytosis), impairment of neutrophil function (defective chemotaxis), and loss of surface Ig of lymphocytes (B lymphocytopenia).
