[Immunoblastic lymphadenopathy-like T cell lymphoma with high levels of serum interleukin-6, cold agglutinin disease, and immune thrombocytopenia].

Abstract

An 88-year-old woman was admitted with generalized lymphadenopathy, anemia, and thrombocytopenia. On admission, a peripheral blood examination showed a red blood cell count of 146 x 10(6)/microliter, a hemoglobin concentration of 6.9 g/dl, and a platelet count of 5.0 x 10(4)/microliter. Blood examination detected polyclonal hypergammaglobulinemia; the results of the direct/indirect Coombs' test were positive; and an elevated cold agglutinin titer and high platelet associated IgG (PA-IgG) level indicated the existence of autoantibodies. Serum cytokine measurements disclosed an elevated level of interleukin-6 (IL-6). Immunoblastic lymphadenopathy-like T cell lymphoma was diagnosed on the basis of lymph node biopsy specimens. VP-16 and steroid therapy alleviated the patient's lymphadenopathy, anemia, thrombocytopenia, and hypergammaglobulinemia. These findings suggest that tumor cells with a T cell phenotype produced IL-6 in large quantities, thus provoking B-cell and plasmacytic histologic changes and humoral disease manifestations, including hypergammaglobulinemia.

• Authors: N Takayanagi, K Sampi
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 39 Issue 11 Pg. 1109-14 (Nov 1998) ISSN: 0485-1439 [Print] Japan
• PMID: 9866423 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Interleukin-6

Topics

• Aged
• Aged, 80 and over
• Anemia, Hemolytic, Autoimmune (etiology)
• Autoimmune Diseases (etiology)
• Female
• Humans
• Immunoblastic Lymphadenopathy (complications)
• Interleukin-6 (blood)
• Lymphoma, T-Cell (complications)
• Thrombocytopenia (etiology)