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Canadian Journal of Gastroenterology
Volume 9, Issue 2, Pages 96-100
http://dx.doi.org/10.1155/1995/820420
Brief Communication

Immune-Mediated Neutropenia and Thrombocytopenia in a Patient with Ulcerative Colitis: An Unusual Hematological Association with IBD

Young-In Kim,1 Aaron Brzezinski,1 Joseph Brandwein,2 and Jeffrey P Baker1

1Division of Gastroenterology and Hematology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
2Division of Hematology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada

Received 5 June 1994; Accepted 20 June 1994

Copyright © 1995 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hematological manifestations of inflammatory bowel disease (IBD) are well described in the literature. However, the combination of immune-mediated neutropenia and thrombocytopenia has only been reported once in association with IBD. A case is reported of immune-mediated neutropenia and thrombocytopenia in a patient with ulcerative colitis during a relapse. No obvious causes of these hematological abnormalities were found in the patient despite an exhaustive search. An immune-mediated process was confirmed by positive antineutrophil antibody and platelet-associated antibody in the patient’s serum, and the demonstration of binding of the patient’s immunoglobulin G to autologous neutrophils. The patient was treated with high-dose steroid, intravenous gamma-globulin and eventually splenectomy. The platelet count subsequently normalized; although the severe neutropenia recurred, it has subsequently improved without further treatment. Although a definitive cause-effect relationship cannot be established, the immune-mediated neutropenia and thrombocytopenia may be an unusual hematological manifestation associated with ulcerative colitis.