Primary immune-mediated neutropenia and precursor-targeted immune-mediated anaemia in a 4-year-old cat

A 4-year-old, female, neutered, domestic shorthair was presented for acute onset of lethargy. The cat had been diagnosed with and treated for precursor-targeted immune-mediated anaemia 2 years before presentation. The clinical examination was unremarkable. Haematology and biochemistry revealed neutropenia and hyperglobulinaemia. Electrophoresis revealed polyclonal gammopathy. Toxoplasma spp. IgG/IgM, Bartonella spp., feline immunodeficiency virus and feline leukaemia virus serology were negative. Urine culture was negative. A computed tomography scan of the thorax and abdomen revealed an enlarged spleen, and cytology was suggestive of reactive lymphoid hyperplasia. Bone marrow aspirates and biopsies were supportive of primary immune-mediated neutropenia and recurrence of precursor-targeted immune-mediated anaemia. The cat was treated successfully with prednisolone and cyclosporine. The necessity to perform a bone marrow biopsy should be highlighted in this case, as the diagnosis of precursor-targeted immune-mediated anaemia and immune-mediated neutropenia was based on bone marrow sampling, exclusion of infectious disorders and response to immunosuppressive medications.