Characterization of the bone marrow immunofluorescence test in childhood autoimmune neutropenia

Lane, S. W., Hassell, P., Kennedy, G. A., Fung, Y. L. and Williams, B. A. (2009) Characterization of the bone marrow immunofluorescence test in childhood autoimmune neutropenia. International Journal of Laboratory Hematology, 31 5: 567-571. doi:10.1111/j.1751-553X.2008.01084.x


Author Lane, S. W.
Hassell, P.
Kennedy, G. A.
Fung, Y. L.
Williams, B. A.
Title Characterization of the bone marrow immunofluorescence test in childhood autoimmune neutropenia
Journal name International Journal of Laboratory Hematology   Check publisher's open access policy
ISSN 1751-5521
1751-553X
Publication date 2009-10-01
Year available 2008
Sub-type Article (original research)
DOI 10.1111/j.1751-553X.2008.01084.x
Open Access Status Not Open Access
Volume 31
Issue 5
Start page 567
End page 571
Total pages 5
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
The bone marrow immunofluorescenece test (BMIFT) demonstrates autoantibodies to granulocytes and their precursors on fresh-frozen bone marrow slides. It may be used to differentiate childhood autoimmune neutropenia (AIN) from other causes of childhood neutropenia, even when circulating neutrophil counts are low. We sought to characterize the diagnostic utility of the BMIFT in childhood AIN. All BMIFT requests for investigation of children with neutropenia between January 1998 and May 2007 were reviewed. Patients were classified as AIN or nonautoimmune causes. Baseline demographic data, results of BMIFT, granulocyte immunofluorescence testing and bone marrow findings were collected from clinical records and the institutional laboratory database. Seventy-six children had BMIFT performed for investigation of neutropenia. There were 45 patients diagnosed with AIN, 28 with 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.
Keyword Autoimmune neutropenia
immunofluorescence
AIN
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Article first published online: 14 JUL 2008

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Wed, 22 Sep 2010, 19:46:43 EST