What are the symptoms of autoimmune lymphoproliferative syndrome (ALPS)?

Patients with autoimmune lymphoproliferative syndrome (ALPS) may have a wide spectrum of symptoms, depending on which component(s) of the body have been compromised by the immune system. In individuals with ALPS, antibodies commonly attack red blood cells, which transport oxygen throughout the body, or platelets, which help in clotting. However, the antibodies may attack cells in almost any location throughout the body, such as the skin, kidney, liver, or nerves. Additional symptoms that patients may experience are highly specific based on the other type(s) of cells that are attacked.

If the immune system attacks red blood cells, patients with ALPS may have a reduction in red blood cell number. Because red blood cells normally transport oxygen to other cells in the body, this may lead to fatigue or weakness. Symptoms that patients with ALPS may develop include an enlarged spleen (due to more blood cells getting stuck there) or enlarged lymph nodes.

If the immune system attacks platelets, patients with ALPS will have a reduction in the number of platelets. Platelets are blood cells that help with the process of clotting. A reduction in platelets may lead to bruises, nosebleeds, increased risk of hemorrhage (excessive bleeding), or the formation of small red or purple spots on the skin called petechiae.

Skin rashes are frequently observed in patients with ALPS, likely due to autoimmune attacks on the skin.

In some patients with ALPS, antibodies may attack other white blood cells that normally fight disease or infection. This can lead to a reduction in the numbers of white blood cells, leaving an individual more susceptible to bacterial infection. Common symptoms of a bacterial infection include fever, sweating, chills, and fast breathing.

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