Kellerer K, Messner H
Wien Klin Wochenschr. 1975 Oct 3;87(18):591-5.
The rare clinical picture of congenital agranulocytosis is described and its differential diagnosis from other forms of chronic neutropenia discussed on the basis of a case report of an infant followed up over a period of 3 years. Characteristic features of the agranulocytosis are inhibited maturation of the neutrophils (only as far as the promyelocyte and immature myelocyte stage), in conjunction with a normal or elevated level of eosinophil granulocytes. Erythropoiesis and megakaryopoiesis are found to be normal; plasmocytes, monocytes and lymphocytes are increased. The consequence of permanent infections is sometimes an excessive hypergammaglobulinaemia. This fact, in combination with the phagocytic activity of the monocytoid cells, enables these children, once out of infancy, to overcome even severe infections much more successfully than would be anticipated from the changes in the white blood picture.
本文通过对一名随访3年的婴儿病例报告,描述了先天性粒细胞缺乏症罕见的临床症状,并讨论了其与其他形式慢性中性粒细胞减少症的鉴别诊断。粒细胞缺乏症的特征性表现为中性粒细胞成熟受阻(仅到早幼粒细胞和未成熟髓细胞阶段),同时嗜酸性粒细胞水平正常或升高。红细胞生成和巨核细胞生成正常;浆细胞、单核细胞和淋巴细胞增多。持续感染的后果有时是过度的高球蛋白血症。这一事实,结合单核样细胞的吞噬活性,使这些儿童一旦度过婴儿期,就能比根据白细胞图像变化预期的更成功地克服甚至严重的感染。