Clonal T cell-mediated cyclic thrombocytopenia.

Abstract

Cyclic thrombocytopenia is a rare disorder characterized by periodic platelet count fluctuations of unknown aetiology. We report on a female patient with cyclic changes of platelet counts ranging from 6 x 10(9)/l to 753 x 10(9)/l in 4-week intervals. Platelet counts were inversely correlated to thrombopoietin levels suggesting production failure. Reticulocyte counts and neutrophil counts showed similar, but less prominent, fluctuations. Clonal T-cell receptor rearrangement was detected in bone marrow samples as well as in peripheral blood. Cell typing of blood lymphocytes revealed a relative increase in CD3+ T cells. Treatment with cyclosporine A resulted in a substantial improvement of platelet counts. Taken together, we provide evidence for clonal T-cell mediated bone marrow failure with cyclic impairment of thrombopoiesis responsive to cyclosporine therapy.

• Authors: Wolfgang Füreder, Gerlinde Mitterbauer, Renate Thalhammer, Klaus Geissler, Simon Panzer, Michael Krebs, Ingrig Simonitsch-Klupp, Wolfgang R Sperr, Klaus Lechner, Paul A Kyrle
• Journal: British journal of haematology (Br J Haematol) Vol. 119 Issue 4 Pg. 1059-61 (Dec 2002) ISSN: 0007-1048 [Print] England
• PMID: 12472588 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunosuppressive Agents
• Cyclosporine
• Thrombopoietin

Topics

• Cyclosporine (therapeutic use)
• Female
• Gene Rearrangement, T-Lymphocyte
• Humans
• Immunophenotyping
• Immunosuppressive Agents (therapeutic use)
• Leukocyte Count
• Middle Aged
• Periodicity
• Platelet Count
• T-Lymphocyte Subsets (immunology)
• Thrombocytopenia (blood, drug therapy, immunology)
• Thrombopoietin (blood)