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Home / Equine Research Bank / J Vet Diagn Invest / Alloimmune neonatal neutropenia and neonatal isoerythrolysis...
Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc2011; 24(1); 219-226; doi: 10.1177/1040638711416850

Alloimmune neonatal neutropenia and neonatal isoerythrolysis in a Thoroughbred colt.

Abstract: A 3-day-old Thoroughbred colt was originally presented for treatment of neonatal isoerythrolysis, which was treated with a blood transfusion. However, persistent neutropenia was observed despite the absence of detectable infection. Subsequently, a granulocyte agglutination test was performed by incubating the colt's neutrophils with the mare's serum; results were positive, leading to a clinical diagnosis of alloimmune neonatal neutropenia. The diagnosis was further supported via flow cytometric analysis. The colt was hospitalized and treated prophylactically with antimicrobials and 4 separate doses of recombinant human granulocyte colony-stimulating factor (rhG-CSF; 1.4-3.5 µg/kg, subcutaneously) in attempts to maintain the neutrophil count within reference intervals over a 4-week period. The colt's neutrophil count increased after administration of rhG-CSF and eventually stabilized within reference intervals by day 20. The colt maintained normal neutrophil counts after discharge and was reportedly healthy at 6 months of age. Alloimmune neonatal neutropenia should be considered in foals with persistent neutropenia in the absence of infection. Alloimmune neonatal neutropenia can be treated with prophylactic antimicrobials combined with rhG-CSF with a favorable outcome.
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Publication Date: 2011-10-06 PubMed ID: 22362958PubMed Central: PMC10619328DOI: 10.1177/1040638711416850Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article discusses the case of a 3-day-old Thoroughbred colt diagnosed with alloimmune neonatal neutropenia and neonatal isoerythrolysis, successfully treated with prophylactic antimicrobials and recombinant human granulocyte colony-stimulating factor (rhG-CSF).

Case Description

  • The Thoroughbred colt was initially diagnosed with neonatal isoerythrolysis, a condition that occurs when the newborn’s own antibodies attack its red blood cells, causing anemia.
  • A blood transfusion was performed to resolve this issue. However, the young colt still showed persistent neutropenia, a low count of neutrophils (a type of white blood cell).

Diagnosis

  • Neutropenia in the absence of detectable infection led veterinarians to suspect another underlying health condition. A granulocyte agglutination test was then conducted, which yielded a positive result.
  • The test involved combining the colt’s neutrophils with the mare’s serum. The positive result indicated an immune response by the colt’s body against its own neutrophils. This led to a clinical diagnosis of alloimmune neonatal neutropenia.
  • The diagnosis was also confirmed via flow cytometric analysis, a method that helps to measure physical and chemical characteristics of biological cells.

Treatment and Outcome

  • After the diagnosis, the colt was hospitalized and was prophylactically given antimicrobial medications. Moreover, 4 isolated doses of recombinant human granulocyte colony-stimulating factor (rhG-CSF) was administrated subcutaneously to stimulate the production of more neutrophils.
  • This treatment regimen was effective. The colt’s neutrophil count elevated after the rhG-CSF administration and stabilized within the normal range after 20 days.
  • The colt continued to maintain normal neutrophil counts after discharge and was still healthy 6 months later.

Implication

  • This case study suggests alloimmune neonatal neutropenia should be considered as a potential diagnosis in foals with consistent neutropenia in the absence of infection.
  • The successful treatment outcome from this case suggests that alloimmune neonatal neutropenia can effectively be managed through a combination of prophylactic antimicrobials and rhG-CSF.

Cite This Article

APA
Wong DM, Alcott CJ, Clark SK, Jones DE, Fisher PG, Sponseller BA. (2011). Alloimmune neonatal neutropenia and neonatal isoerythrolysis in a Thoroughbred colt. J Vet Diagn Invest, 24(1), 219-226. https://doi.org/10.1177/1040638711416850

Publication

Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc
ISSN: 1943-4936
NlmUniqueID: 9011490
Country: United States
Language: English
Volume: 24
Issue: 1
Pages: 219-226

Researcher Affiliations

Wong, David M
  • Lloyd Veterinary Medical Center, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA.
Alcott, Cody J
    Clark, Sandra K
      Jones, Douglas E
        Fisher, Phyllis G
          Sponseller, Brett A

            MeSH Terms

            • Animals
            • Animals, Newborn / immunology
            • Anti-Infective Agents / therapeutic use
            • Blood Transfusion / veterinary
            • Diagnosis, Differential
            • Erythroblastosis, Fetal / diagnosis
            • Erythroblastosis, Fetal / therapy
            • Erythroblastosis, Fetal / veterinary
            • Flow Cytometry / veterinary
            • Granulocyte Colony-Stimulating Factor / therapeutic use
            • Horse Diseases / diagnosis
            • Horse Diseases / immunology
            • Horses
            • Leukocyte Count / veterinary
            • Male
            • Neutropenia / diagnosis
            • Neutropenia / drug therapy
            • Neutropenia / immunology
            • Neutropenia / veterinary
            • Neutrophils
            • Recombinant Proteins / therapeutic use

            Grant Funding

            • R15 HL103488 / NHLBI NIH HHS
            • R15 HL103 488-01 / NHLBI NIH HHS

            Conflict of Interest Statement

            Declaration of conflicting interests. The authors declared that they had no conflicts of interests in their authorship and publication of this contribution.

            References

            This article includes 40 references
            1. Ambrose LR, Morel AS, Warrens AN. Neutrophils express CD52 and exhibit complement-mediated lysis in the presence of alemtuzumab.. Blood 114:3052–3055.
              pubmed: 19638623
            2. Anthony RM, Wermeling F, Karlsson MC. Identification of a receptor required for the anti-inflammatory activity of IVIG.. Proc Natl Acad Sci U S A 105:19571–19578.
              pmc: PMC2604916pubmed: 19036920
            3. Bailey E. Prevalence of anti-red blood cell antibodies in the serum and colostrum of mares and its relationship to neonatal isoerythrolysis.. Am J Vet Res 43:1917–1921.
              pubmed: 7181190
            4. Bianco D, Armstrong PJ, Washabau RJ. Treatment of severe immune-mediated thrombocytopenia with human IV immunoglobulin in 5 dogs.. J Vet Intern Med 21:694–699.
              pubmed: 17708388
            5. Bianco D, Armstrong PJ, Washabau RJ. A prospective, randomized, double-blinded, placebo-controlled study of human intravenous immunoglobulin for the acute management of presumptive primary immune-mediated thrombocytopenia in dogs.. J Vet Intern Med 23:1071–1078.
              pubmed: 19674280
            6. Boyle AG, Magdesian KG, Ruby RE. Neonatal isoerythrolysis in horse foals and a mule foal: 18 cases (1988–2003).. J Am Vet Med Assoc 227:1276–1283.
              pubmed: 16266017
            7. Brecher ME. Reading and grading tube agglutination.. American Association of Blood Banks technical manual 15th ed., pp. 728–730. AABB, Bethesda, MD.
            8. Brown CD, Parnell NK, Schulman RL. Evaluation of clinicopathologic features, response to treatment, and risk factors associated with idiopathic neutropenia in dogs: 11 cases (1990–2002).. J Am Vet Med Assoc 229:87–91.
              pubmed: 16817719
            9. Brown MR, Rodgers KS. Neutropenia in dogs and cats: a retrospective study of 261 cases.. J Am Anim Hosp Assoc 37:131–139.
              pubmed: 11300519
            10. Bux J. Granulocyte immunology.. Wien Klin Wochenschr 113:799–805.
              pubmed: 11732115
            11. Bux J, Chapman J. Report on the second international granulocyte serology workshop.. Transfusion 37:977–983.
              pubmed: 9308648
            12. Bux J, Jung KD, Kauth T, Mueller-Eckhardt C. Serological and clinical aspects of granulocyte antibodies leading to alloimmune neonatal neutropenia.. Transfus Med 2:143–149.
              pubmed: 1284978
            13. Calhoun DA, Christensen RD, Edstrom CS. Consistent approaches to procedures and practices in neonatal hematology.. Clin Perinatol 27:733–753.
              pubmed: 10986638
            14. Crow AR, Song S, Siragam V, Lazarus AH. Mechanisms of action of intravenous immunoglobulin in the treatment of immune thrombocytopenia.. Pediatr Blood Cancer 47:710–713.
              pubmed: 16933274
            15. Davis EG, Rush B, Bain F. Neonatal neutropenia in an Arabian foal.. Equine Vet J 35:517–520.
              pubmed: 12875333
            16. Ellenberger MA, Kaeberle ML, Roth JA. Effect of Rhodococcus equi on equine polymorphonuclear leukocyte function.. Vet Immunol Immunopathol 7:315–324.
              pubmed: 6506452
            17. Gilmore MM, Stroncek DF, Korones DN. Treatment of alloimmune neonatal neutropenia with granulocyte colony-stimulating factor.. J Pediatr 125:948–951.
              pubmed: 7527850
            18. Hagimoto R, Koike K, Sakashita K. A possible role for maternal HLA antibody in a case of alloimmune neonatal neutropenia.. Transfusion 41:615–620.
              pubmed: 11346696
            19. Hammond WP, Csiba E, Canin A. Chronic neutropenia. A new canine model induced by human granulocyte colony-stimulating factor.. J Clin Invest 87:704–710.
              pmc: PMC296362pubmed: 1704019
            20. Hoftman AC, Hernandez MI, Lee KW, Stiehm ER. New-born illnesses caused by transplacental antibodies.. Adv Pediatr 55:271–304.
              pubmed: 19048734
            21. Hullinger PJ, Wilson WD, Rossitto PV. Passive transfer, rate of decay, and protein specificity of antibodies against equine arteritis virus in horses from a Standardbred herd with high seroprevalence.. J Am Vet Med Assoc 213:839–842.
              pubmed: 9743724
            22. Jain NC, Stott JL, Vegad JL, Dhawedkar RG. Detection of anti-equine neutrophil antibody by use of flow cytometry.. Am J Vet Res 52:1883–1890.
              pubmed: 1785733
            23. Kaneko Y, Nimmerjahn F, Ravetch JV. Anti-inflammatory activity of immunoglobulin G resulting from Fc sialylation.. Science 313:670–673.
              pubmed: 16888140
            24. Kazatchkine MD, Kaveri SV. Immunomodulation of autoimmune and inflammatory diseases with intravenous immune globulin.. N Engl J Med 345:747–755.
              pubmed: 11547745
            25. Kumar S, Kumar R, Gupta AK, Dwivedi SK. Passive transfer of Theileria equi antibodies to neonate foals of immune tolerant mares.. Vet Parasitol 151:80–85.
              pubmed: 18022185
            26. Latini G, Del Vecchio A, Rosati E. Different responses to granulocyte colony-stimulating factor treatment in siblings with alloimmune neonatal neutropenia.. Acta Paediatr 88:1407–1409.
              pubmed: 10626532
            27. Maheshwari A, Christensen RD, Calhoun DA. Immune-mediated neutropenia in the neonate.. Acta Paediatr Suppl 91:98–103.
              pubmed: 12477271
            28. Maheshwari A, Christensen RD, Calhoun DA. Immune neutropenia in the neonate.. Adv Pediatr 49:317–339.
              pubmed: 12214777
            29. Perkins GA, Miller WH, Divers TJ. Ulcerative dermatitis, thrombocytopenia, and neutropenia in neonatal foals.. J Vet Intern Med 19:211–216.
              pubmed: 15822566
            30. Perkins MC, Canfield P, Churcher RK, Malik R. Immune-mediated neutropenia suspected in five dogs.. Aust Vet J 82:52–57.
              pubmed: 15088959
            31. Platt R, Sponseller BA, Chiang YW, Roth JA. Cell-mediated immunity evaluation in foals infected with virulent equine herpesvirus-1 by multi-parameter flow cytometry.. Vet Immunol Immunopathol 135:275–281.
              pubmed: 20116862
            32. Putsche JC, Kohn B. Primary immune-mediated thrombocytopenia in 30 dogs (1997–2003).. J Am Anim Hosp Assoc 44:250–257.
              pubmed: 18762561
            33. Scheurlen W, Ramasubbu K, Wachowski O. Chronic autoimmune thrombopenia/neutropenia in a boy with persistent parvovirus B19 infection.. J Clin Virol 20:173–178.
              pubmed: 11166667
            34. Sponseller BA, de Macedo MM, Clark SK. Activation of peripheral blood monocytes results in more robust production of IL-10 in neonatal foals compared to adult horses.. Vet Immunol Immunopathol 127:167–173.
              pubmed: 18976818
            35. Taniuchi S, Masuda M, Yamamoto A. Two cases of autoimmune neutropenia possibly induced by beta-lactam antibiotics in infants.. J Pediatr Hematol Oncol 22:533–538.
              pubmed: 11132223
            36. Tumas DB, Brassfield AL, Travenor AS. Monoclonal antibodies to the equine CD2 T lymphocyte marker, to a pan-granulocyte/monocyte marker and to a unique pan-B lymphocyte marker.. Immunobiology 192:48–64.
              pubmed: 7750989
            37. Whelan MF, O’Toole TE, Chan DL. Use of human immunoglobulin in addition to glucocorticoids for the initial treatment of dogs with immune-mediated hemolytic anemia.. J Vet Emerg Crit Care (San Antonio) 19:158–164.
              pubmed: 19691566
            38. Williams BA, Fung YL. Alloimmune neonatal neutropenia: can we afford the consequences of a missed diagnosis?. J Paediatr Child Health 42:59–61.
              pubmed: 16487391
            39. Yoshida N, Shikata T, Sudo S. Alloimmune neonatal neutropenia in monozygous twins. High-dose intravenous gammaglobulin therapy.. Acta Paediatr Scand 80:62–65.
              pubmed: 2028791
            40. Zinkl JG, Madigan JE, Fridmann DM. Haematological, bone marrow and clinical chemical changes in neonatal foals given canine recombinant granulocyte-colony stimulating factor.. Equine Vet J 26:313–318.
              pubmed: 8575399

            Citations

            This article has been cited 1 times.
            1. Endo Y, Hobo S, Korosue K, Ootsuka K, Kitauchi A, Kikkawa R, Hidaka Y, Hagio M, Tsuzuki N. Effects of low-dose G-CSF formulation on hematology in healthy horses after long-distance transportation. J Vet Med Sci 2015 Apr;77(4):507-9.
              doi: 10.1292/jvms.14-0586pubmed: 25648988google scholar: lookup
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