Autoimmune Thrombozytopenie, Neutropenie und H?molyse |
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Authors: | Prof Dr A Greinacher J Bux A Salama |
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Institution: | 1. Institut für Immunologie und Transfusionsmedizin, Universit?tsklinikum, Ernst-Moritz-Arndt-Universit?t Greifswald, Sauerbruchstra?e, 17487, Greifswald, Deutschland 2. DRK-Blutspendedienst West, Hagen, Deutschland 3. Institut für Transfusionsmedizin, Charité – Universit?tsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
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Abstract: | Autoantibodies reduce the life span of platelets, granulocytes, and red blood cells. This may result in thrombocytopenia with bleeding, in neutropenia with infection, and in anemia, respectively. Immune-hemocytopenias can manifest as primary disease without another cause, or they are associated with other underlying morbidities such as autoimmune diseases, lymphoproliferative diseases, immune defects, or viral infections. Diagnosis is confirmed by laboratory tests showing autoantibodies against the respective blood cells. Indication for treatment is the clinical manifestation of symptoms: bleeding in autoimmune thrombocytopenia, infections in neutropenia, and symptomatic anemia, respectively. Especially in case of thrombocytopenia patients should not be treated because of abnormal laboratory values, only. To date steroids are the basic treatment in autoimmune thrombocytopenia and hemolytic anemia, while prophylactic antibiotics are the main treatment in autoimmune neutropenia. Growth factors like the new thrombopoietin receptor agnonists in autoimmune thrombocytopenia or G-CSF in autoimmune neutropenia, and anti-CD20 antibodies are new options for treatment. |
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