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Antigen-Capture Enzyme-Linked Immunosorbent Assay for Specific Detection of Mycoplasma pneumoniae
Published on: February 24, 2023
Transient immune-mediated agranulocytosis following Mycoplasma pneumoniae infection
Luani Barge1, Gail Pahn2, Nicholas Weber1,3
1Haematology Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Abstract:
Mycoplasma pneumoniae is a common respiratory pathogen which may cause haematological manifestations including haemolytic anaemia and thrombocytopaenia. Severe neutropaenia is rare with very few cases reported in the literature. An 85-year-old man was transferred to our facility with agranulocytosis in the context of an infective exacerbation of chronic obstructive pulmonary disease with positive serological testing for M. pneumoniae. No alternative infective, autoimmune or lymphoproliferative cause of the neutropaenia was identified. Granulocyte autoantibody testing was performed with a positive result for neutrophil-bound IgG and IgM autoantibodies and significant agglutination reactions. The patient was treated with azithromycin and granulocyte colony-stimulating factor which resulted in a sustained resolution of his neutropaenia.
Insights
Mycoplasma pneumoniae infection can rarely cause severe neutropenia (low white blood cell count). This case highlights a potential link and successful treatment with azithromycin and G-CSF.
Area of Science:
- Hematology
- Infectious Diseases
- Immunology
Background:
- Mycoplasma pneumoniae is a common respiratory pathogen.
- It can cause various hematological issues, such as hemolytic anemia and thrombocytopenia.
- Severe neutropenia is an uncommon but serious manifestation.
Observation:
- An 85-year-old male patient presented with agranulocytosis during an exacerbation of chronic obstructive pulmonary disease.
- Serological testing confirmed Mycoplasma pneumoniae infection.
- No other causes for neutropenia were identified, and the patient tested positive for neutrophil autoantibodies.
Findings:
- The patient's neutropenia was directly linked to Mycoplasma pneumoniae infection.
- Treatment with azithromycin and granulocyte colony-stimulating factor (G-CSF) led to a complete and sustained recovery of neutrophil counts.
Implications:
- This case underscores the importance of considering Mycoplasma pneumoniae as a potential cause of severe neutropenia, even in elderly patients.
- Early diagnosis and appropriate treatment, including antibiotics and G-CSF, can lead to favorable outcomes.
- Further research may elucidate the immunological mechanisms underlying this rare complication.
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