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T Nagasawa, T Sakurai, H Kashiwagi and T Abe
We studied a patient with a rare complication of amegakaryocytic
thrombocytopenia (AMT) associated with systemic lupus erythematosus (SLE).
To investigate the underlying pathogenesis of AMT, the effects of
peripheral blood T cells and serum on human megakaryocyte progenitor cells
were studied using in vitro coculture techniques. Mononuclear bone marrow
cells (2 X 10(5) from normal donors produced 33.6 +/- 8.8 (n = 10)
colony-forming unit-megakaryocytes (CFU-M) in our plasma clot system. When
2 X 10(5) of the patient's T cells were added to the culture system, the
number of CFU-M decreased to only 3.5 +/- 0.6/2 X 10(5) bone marrow cells.
No evidence of inhibitory effects was found by the addition of the
patient's serum and complement to the culture system. The T cells stored at
-80 degrees C on admission were also capable of suppressing autologous
CFU-M after recovery from AMT. These results indicate that in vitro
suppression of CFU-M from allogenic and autologous bone marrow cells by
this patient's T cells provides an explanation for the pathogenesis of AMT
associated with SLE.
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