Autoimmune neutropenia with anti-neutrophil autoantibody associated with Sjögren's syndrome

A 74-year-old man developed neutropenia in association with Sjögren's syndrome. The peripheral neutrophils in his blood decreased to 210/mm3 (total white blood cell count 2,100/mm3). Bone marrow examination showed an increase in the number of neutrophil precursors. The presence of anti-neutrophil autoantibody (ANAB) in his plasma was determined by an enzyme-linked immunosorbent assay. Prednisolone therapy resulted in an increase in the neutrophil count and a decrease in the ANAB titer. However, when the daily dose of prednisolone was decreased, the neutrophil count gradually decreased, and the ANAB titer increased again. These results suggest that neutropenia in this patient was caused by ANAB, and ANAB could be the result of autoimmune disorders associated with Sjögren's syndrome.