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Q J Med 1990; 74: 57-61
© 1990 Association of Physicians

other

Antibody-mediated Pure Neutrophil Aplasia, Recurrent Myasthenia Gravis and Previous Thymoma: Case Report and Literature Review

P. W. MATHIESON{ddagger}, J. H. O'NEILL§, S. T. S. DURRANT*, S. J. HENDERSON*, P. J. GREEN{dagger} and J. NEWSOM-DAVIS

Department of Clinical Neurology, National Hospital for Nervous Diseases Queen Square, London WC1 *Department of Haematology, Leicester Royal Infirmary Leicester LE1 5WW {dagger}St Mary's Hospital Portsmouth PO3 6AD

Address correspondence to Professor J. Newsom-Davis, Neurosciences Group, Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU

Accepted for publication 16 June 1989.

We describe a case of neutrophil aplasia in a woman with recurrent myasthenia gravis and a past history of thymoma. Bone marrow showed virtually absent granulopoiesis but normal erythropoiesis and megakaryopoiesis. Bone marrow cultures showed no growth of granulocyte/ mononuclear cell progenitors (CFU-GM). She was treated with immunosuppression including azathioprine, and her neutrophil count returned to normal. Serum before treatment, and also an IgG fraction thereof, inhibited CFU-GM growth both in autologous ‘remission’ marrow and in allogeneic marrow. She remains in complete remission 36 months after starting azathioprine.

This association is extremely rare, and was formerly associated with a grim prognosis.

{ddagger} Present address: c/o Office of the Regius Professor of Physic, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ.

§ Present address: Department of Neurology, St. Vincent's Hospital, Victoria Street, Darlinghurst, NSW 2010, Australia.


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