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Characterization of the bone marrow immunofluorescence test in childhood autoimmune neutropenia
Journal article   Peer reviewed

Characterization of the bone marrow immunofluorescence test in childhood autoimmune neutropenia

S W Lane, P Hassell, G A Kennedy, Yoke Lin Fung and B A Williams
International Journal of Laboratory Hematology, Vol.31(5), pp.567-571
2009
url
https://doi.org/10.1111/j.1751-553X.2008.01084.xView
Published Version

Abstract

Autoimmune neutropenia immunofluorescence AIN
SUMMARY he bone marrow immunofluorescenece test (BMIFT) demonstrates utoantibodies to granulocytes and their precursors on fresh-frozen one marrow slides. It may be used to differentiate childhood utoimmune neutropenia (AIN) from other causes of childhood eutropenia, even when circulating neutrophil counts are low. We ought to characterize the diagnostic utility of the BMIFT in childhood IN. All BMIFT requests for investigation of children with neutropenia ween January 1998 and May 2007 were reviewed. Patients were lassified as AIN or nonautoimmune causes. Baseline demographic ata, results of BMIFT, granulocyte immunofluorescence testing and one marrow findings were collected from clinical records and the stitutional laboratory database. Seventy-six children had BMIFTperformed for investigation of neutropenia. There were 45 patients diagnosed with AIN, 28with nonimmune neutropenia and three failed tests. The median age of children with AIN was 1.2 years (range 0.3- 15.3), compared with 3.6 years (range 0.1-15.7) in the nonautoimmune group. The median neutrophil count in AIN was 0.3 . 109/l (0.9 . 109/l in nonautoimmune). BMIFT was positive in 24 of 45 patients with AIN and 0 of 28 with nonautoimmune neutropenia (sensitivity 53%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value 57%). Ten patients had other autoimmune diatheses at diagnosis. The BMIFT is a simple, highly specific test with excellent PPV and thus is a clinically useful test to confirm AIN in children. © 2008 Blackwell Publishing Ltd.

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