[Preliminary study of "erythroblast island" in the bone marrow of hematocytopenic XXXX with positive BMMNC-Coombs test.]

@entity1 @entity17731
OBJECTIVE: To explore the mechanism of 'erythroblast island (EI)' formation in the bone marrow of @entity1 with immun-related hemocytopenia ( @entity17731 ). METHODS: The category of BM-auto antibody (au Ab) in 48 @entity1 with @entity17731 was detected with FCM. The BM-au Ab in the 'EI' of these cases were explored with immuonhistofluorescence (IF). Clinical and laboratory characteristics of these cases were also analyzed retrospectively. RESULTS: IgG could be detected in the 'EI' on the BM smear of 14 cases (29.17%), BM-au Ab mainly deposited at the edge/membranes between macrophage and erythroblasts rather than cyto plasm. Positive reaction were seen in all the cases with GlycoAIgG. The red blood cell count [(1.8    0.5)   10(12)/L] and hemoglobin level [(59.6    16.2)g/L] were significantly lower than that in the IF(-) group [(2.5    0.9)   10(12)/L and (83.4    25.0) g/L] (P < 0.05). The percentage of reticulocyte [(2.0    0.8)%], serum level of IBIL [(9.4    4.7)   mol/L], percentage of erythroblats in sternum BM (0.441    0.139) and response rate to therapy (85.7%) in IF(+) group were significantly higher than that in IF(-)group [(1.3    1.0)%, (6.6    6.7)  mol/L, 0.298    0.082, 61.3%, respectively] (P < 0.05). CONCLUSION: Macrophage was connected with erythroblasts through autologous IgG in the 'EI's of some @entity1 with @entity17731 . 'EI' were the places where macrophages devoured and destroyed erythroblasts rather than erythroid development and differentiation. The pathogenetic mechanism of @entity17731 might be associated with macrophages phagocytosing and destroying BM hematopoietic cells.
