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Abnormal NK Cell Lymphocytosis Detected after Splenectomy: Association with Repeated Infections, Relapsing Neutropenia, and Persistent Polyclonal B-Cell Proliferation

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Abstract

We report the case of a boy with hereditary spherocytosis who presented with mild microcytic hypochromic anemia and recurrent leg ulcers that had been present since childhood. Chronic natural killer (NK) cell and B-cell lymphocytosis was detected 1 year after therapeutic splenectomy during investigation of recurrent episodes of neutropenia and persistent lymphocytosis. NK cells proved to be abnormal at immunophenotyping studies, and B-cells were polyclonal and displayed a normal immunophenotype. Genotypic analysis of T-cell receptor (TCR)-β and TCR-γ genes showed a germ-line pattern. The clinical course of this patient was characterized by multiple pulmonary infections and amygdalitis. We discuss the potential roles of persistent immune stimulation due to chronic hemolysis and severe leg ulcers and of splenectomy in the origin of NK cell lymphocytosis and the relationship between NK cells and recurrent infections, relapsing neutropenia, and polyclonal B-cell response.Int J Hematol. 2002;75:484–488.

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Correspondence to Elisa Granjo or Margarida Lima or Manuela Fraga or Filipe Santos or Conceição Magalhães or Maria Luís Queirós or Ilidia Moreira or Sandra Rocha or Alice Santos Silva or Irene Rebelo or Alexandre Quintanilha or Maria Letícia Ribeiro or Jorge Candeias or Alberto Orfão.

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Granjo, E., Lima, M., Fraga, M. et al. Abnormal NK Cell Lymphocytosis Detected after Splenectomy: Association with Repeated Infections, Relapsing Neutropenia, and Persistent Polyclonal B-Cell Proliferation. Int J Hematol 75, 484–488 (2002). https://doi.org/10.1007/BF02982110

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Key words

  • NK cells
  • Neutropenia
  • B-cells
  • Spherocytosis
  • Splenectomy