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Myelosuppression in Legionnaires' disease
Archives of Internal Medicine
|July 1, 1982
Summary
Legionnaires' disease in a patient with renal insufficiency was linked to a serum factor inhibiting granulocyte colony growth. This inhibitor, not the patient's medications, caused granulocytopenia during severe pneumonia.
Area of Science:
- Infectious Diseases
- Hematology
- Immunology
Background:
- A patient with renal insufficiency developed severe pneumonia caused by Legionella pneumophila.
- The patient's condition was complicated by granulocytopenia, a significant decrease in granulocytes.
Observation:
- Bone marrow aspiration revealed marked inhibition of myelopoiesis across all maturation stages.
- In vitro bone marrow culture demonstrated a serum inhibitor of granulopoiesis.
Findings:
- Normal bone marrow cultured with patient serum produced significantly fewer granulocyte colonies (14.3 +/- 2.3) compared to normal serum (69 +/- 5.2 and 61 +/- 5).
- Therapeutic concentrations of the patient's medications did not suppress granulocyte colony formation in vitro, ruling them out as the cause.
Implications:
- Legionnaires' disease can be associated with a serum factor that inhibits granulocyte colony growth.
- This finding suggests a potential mechanism for the granulocytopenia observed in some severe Legionella infections.