Autoimmune neutropenia preceding Helicobacter pylori-negative MALT lymphoma with nodal dissemination

Int J Clin Exp Pathol. 2014 Aug 15;7(9):6386-90. eCollection 2014.

Abstract

Autoimmune neutropenia (AIN), resulting from granulocyte-specific autoantibodies, is much less frequent than other autoimmune hematologic disorders including autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). These autoimmune disorders may precede, synchronize, or follow collagen disorders, viral infections, and lymphoid neoplasms. Herein we present the first case of AIN in association with Helicobacter pylori-negative mucosa-associated lymphoid tissue (MALT) lymphoma with nodal dissemination. In our case, AIN, accompanied by ITP, occurred prior to the clinical manifestation of lymphoma. AIN and ITP were well managed afterwards, but they relapsed in accordance with the recurrence of lymphoma. The administration of prednisolone at 0.5 mg/kg daily alleviated the cytopenias within a week. In general, combination chemotherapy is performed for the treatment of lymphoma-associated autoimmune hematologic disorders and indeed seems to be effective. Our case indicates that corticosteroid monotherapy may be effective for lymphoma-associated AIN especially when AIN precedes the onset of lymphoma.

Keywords: MALT lymphoma; autoimmune neutropenia; combination chemotherapy; corticosteroid; immune thrombocytopenia.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antineoplastic Agents / administration & dosage
  • Biomarkers, Tumor / analysis
  • Biopsy
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Immunohistochemistry
  • Lymphatic Metastasis
  • Lymphoma, B-Cell, Marginal Zone / diagnosis
  • Lymphoma, B-Cell, Marginal Zone / drug therapy
  • Lymphoma, B-Cell, Marginal Zone / immunology*
  • Neutropenia / diagnosis
  • Neutropenia / drug therapy
  • Neutropenia / immunology*
  • Positron-Emission Tomography
  • Prednisolone / administration & dosage
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy
  • Purpura, Thrombocytopenic, Idiopathic / immunology*
  • Recurrence
  • Rituximab
  • Time Factors
  • Treatment Outcome
  • Whole Body Imaging / methods

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Glucocorticoids
  • Rituximab
  • Prednisolone