Epidermolysis bullosa acquisita induced by GM‐CSF: a role for eosinophils in treatment‐related toxicity

Jeffery C. Ward, Jeffrey B. Gitlin, Daniel J. Garry, Aminah Jatoi, Sharon D. Luikart, Brian D. Zelickson, Mark V. Dahl, Keith M. Skubitz

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

A patient treated with granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) developed eosinophilia and epidermolysis bullosa acquisita. The bullae were subepi‐dermal, and filled with an inflammatory infiltrate composed predominantly of eosinophils. Immunofluorescence studies disclosed linear deposition of IgG, IgA and C3 at the basement membrane zone and immunoelectron microscopy demonstrated antibody deposition in the lamina densa and sub‐lamina densa region; however, the patient's serum did not contain circulating antibody to basement membrane zone antigens. Staining with monoclonal antibodies revealed dense deposits of both eosinophil peroxidase and eosinophil major basic protein at the dermal–epidermal junction. The eosinophilia and skin lesions resolved upon discontinuation of GM‐CSF. This case provides evidence for two hypotheses: (1) GM‐CSF induced proliferation and activation of eosinophils may contribute to some of the toxicities of GM‐CSF treatment, and (2) activated granulocytes, including eosinophils, may mediate blister formation in epidermolysis bullosa acquisita.

Original languageEnglish (US)
Pages (from-to)27-32
Number of pages6
JournalBritish journal of haematology
Volume81
Issue number1
DOIs
StatePublished - May 1992

ASJC Scopus subject areas

  • Hematology

Fingerprint Dive into the research topics of 'Epidermolysis bullosa acquisita induced by GM‐CSF: a role for eosinophils in treatment‐related toxicity'. Together they form a unique fingerprint.

  • Cite this

    Ward, J. C., Gitlin, J. B., Garry, D. J., Jatoi, A., Luikart, S. D., Zelickson, B. D., Dahl, M. V., & Skubitz, K. M. (1992). Epidermolysis bullosa acquisita induced by GM‐CSF: a role for eosinophils in treatment‐related toxicity. British journal of haematology, 81(1), 27-32. https://doi.org/10.1111/j.1365-2141.1992.tb08166.x