IMMUNE-MEDIATED NEUTROPENIA AND THROMBOCYTOPENIA IN A PATIENT WITH ULCERATIVE-COLITIS - AN UNUSUAL HEMATOLOGICAL ASSOCIATION WITH IBD

Hematological manifestations of inflammatory bowel disease (IBD) are w ell described in the literature, However, the combination of immune-me diated neutropenia and thrombocytopenia has only been reported once in association with IBD. A case is reported of immune-mediated neutropen ia and thrombocytopenia in a patient with ulcerative colitis during a relapse. No obvious causes of these hematological abnormalities were f ound in the patient despite an exhaustive search. An immune-mediated p rocess was confirmed by positive antineutrophil antibody and platelet- associated antibody in the patient's serum, and the demonstration of b inding of the patient's immunoglobulin G to autologous neutrophils. Th e patient was treated with. high-dose steroid, intravenous gammaglobul in and eventually splenectomy. The platelet count subsequently normali zed; although the severe neutropenia recurred, it has subsequently imp roved without further treatment. Although a definitive cause-effect re lationship cannot be established, the immune-mediated neutropenia and thrombocytopenia may be an unusual hematological manifestation associa ted with ulcerative colitis.