[Antibodies, clinical and hematologic findings in immunoneutropenias]

Sera were analyzed from patients who were suspected to have antibodies to neutrophils. The analysis comprised five methods which avoid heterologous antibodies to human immunoglobulin. These methods were the granulocyte agglutination test (GAT), the granulocyte cytotoxicity test (GCT), the monocyte cytotoxicity test (MCT), the lymphocyte cytotoxicity test (LCT) and immune phagocytosis inhibition test (IPI). Each serum was tested with cells from five healthy donors, at least, and some with cells from relatives. After exclusion of sera containing multiple antibodies and HLA-antibodies with positive LCT- and IPI-tests, the GAT- or GCT-reactive antibodies were significantly (p = 0.00005) more frequent among patients with neutrophil counts less than or equal to 1.0 X 10(9)/l (30%; n = 117) than among patients with neutrophil counts greater than 1.0 X 10(9)/l (9%; n = 111). Within the group of neutropenic patients (less than or equal to 1.0 X 10(9)/l) these antibodies were significantly (p = 0.001) more frequent in patients without (48%; n = 46) than with reduction of the granulopoiesis (13%; n = 31). This typical feature of an immune cytopenia also could be shown with GAT-reactive antibodies alone. From all five antibody tests the diagnostic criteria of the autoimmune neutropenia (AINP) and neonatal alloimmune neutropenia (NIN) were infered. 25 patients with clearly defined AINP presented with significantly more infectious complication than 23 patients with only assumed AINP (48% versus 13%). Further, the clinical findings of eight patients with NIN were described. --Antibodies only reactive in the GAT were detected in healthy individuals (1.3%; n = 75) and patients without indication for AINP or NIN (8%; n = 111), also.(ABSTRACT TRUNCATED AT 250 WORDS)