Córdova Calderón Wilmer, Pérez Rojas Javier, Galván Calle César, Blancas Galicia Lizbeth
Unidad de Inmunología del Hospital Guillermo Almenara Irigoyen, Lima, Perú.
Rev Alerg Mex. 2010 Sep-Oct;57(5):176-81.
Severe congenital neutropenia is a primary immunodeficiency; the lack of maturation of neutrophil precursor in bone marrow and severe neutropenia are the subjacent characteristics which explain a marked susceptibility to severe and recurrent infections; bacteria and fungi are the most common etiologic agents. We report the case of an infant with severe congenital neutropenia that began at 4 days from birth with perianal abscess infections, sepsis, liver abscess, gingivitis and oral ulcers; she required multiple hospitalizations because of the severity of the infections. Isolated agents were Pseudomonas aeruginosa, Staphylococcus hominis and Klebsiella sp. The bone marrow examination showed maturation arrest of myeloid forms, thus confirming the diagnosis of severe congenital neutropenia. Granulocyte colony-stimulating factor was started. The severe congenital neutropenia should be considered in patients with neutropenia and infections in the first month of life. Early diagnosis and treatment improve survival and quality of life of these patients.
严重先天性中性粒细胞减少症是一种原发性免疫缺陷病;骨髓中中性粒细胞前体成熟障碍及严重中性粒细胞减少是其基本特征,这解释了患者对严重反复感染具有显著易感性;细菌和真菌是最常见的病原体。我们报告一例严重先天性中性粒细胞减少症婴儿病例,该患儿出生4天时即出现肛周脓肿感染、败血症、肝脓肿、牙龈炎和口腔溃疡;由于感染严重,她需要多次住院治疗。分离出的病原体为铜绿假单胞菌、人葡萄球菌和克雷伯菌属。骨髓检查显示髓系细胞成熟停滞,从而确诊为严重先天性中性粒细胞减少症。开始使用粒细胞集落刺激因子治疗。对于出生后第一个月内出现中性粒细胞减少和感染的患者,应考虑严重先天性中性粒细胞减少症。早期诊断和治疗可提高这些患者的生存率和生活质量。