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Neutrophil and platelet antibodies in autoimmune lymphoproliferative syndrome
Author(s) -
Kwon S.W.,
Procter J.,
Dale J. K.,
Straus S. E.,
Stroncek D. F.
Publication year - 2003
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.0042-9007.2003.00374.x
Subject(s) - antibody , immunology , antigen , granulocyte , neutrophil extracellular traps , epitope , medicine , monoclonal antibody , inflammation
Background and Objectives Autoimmune lymphoproliferative syndrome (ALPS), is an inherited disorder characterized by defective lymphocyte apoptosis, lymphadenopathy, splenomegaly, accumulation of T‐cell receptor (TCR)‐αβ + CD4 − CD8 − T cells (double‐negative T cells) and autoimmunity. We investigated the incidence and nature of neutrophil and platelet antibodies in patients with ALPS. Materials and Methods Sera from 26 patients with ALPS were tested for neutrophil antibodies by granulocyte immunofluorescence, granulocyte agglutination and monoclonal antibody immobilization assays of granulocyte antigens, and for platelet antibodies using a solid‐phase antibody‐detection system. Results Neutrophil antibodies were detected in 46% of patients with ALPS. Antibody specificity could be defined in eight of the 12 patients with neutrophil antibodies. Among these eight patients, four had antibodies directed against more than one antigen. Overall, 14 antibodies directed to specific antigens were identified: three were directed to the HNA‐1a antigen of FcγRIIIb; two to the HNA‐1b antigen of Fcγ‐RIIIb; two to epitopes common to all FcγRIIIb molecules; four to the HNA‐2a antigen of the NB1 glycoprotein; and three to neutrophil β 2 integrins. Platelet antibodies were detected in 35% of patients with ALPS. No antibody specificities were identified among the platelet antibodies. There was no association between the detection of neutrophil antibodies and a history of clinical neutropenia, or between the detection of platelet antibodies and a history of clinical thromobocytopenia. Conclusions Neutrophil and platelet antibodies are important markers of ALPS, but do not always cause clinical cytopenias. The specificities of neutrophil antibody were similar to those found in children with autoimmune neutropenia but without ALPS.