Gupta Abhishek, Dhingra Anurag
Geriatrics, Center for Addiction and Mental Health.
Family Medicine, Star Medical Center, Mississauga, On, Canada.
Cureus. 2017 Oct 17;9(10):e1779. doi: 10.7759/cureus.1779.
Chronic neutropenia is a rare hematologic abnormality encountered in primary care. It can be caused by a wide range of acquired and congenital factors. Very rarely, it can occur as isolated chronic neutropenia where other hematologic cell lines are completely intact. The case discussed here dealt with a similar situation where a 29-year-old female patient presented with severe neutropenia and otherwise intact cell lines in an asymptomatic fashion. Laboratory testing conducted at multiple intervals showed a consistently and severely depressed absolute neutrophil count (ANC) for a prolonged time. In addition, the patient had some abnormalities in serum immunoglobulin levels that pointed towards an underlying autoimmune or malignant pathology but these were insufficient to arrive at a clear diagnosis. The unique presentation in this patient presents an opportunity to study the pathological causation for neutropenia and, more specifically, isolated neutropenia.
慢性中性粒细胞减少症是基层医疗中罕见的血液学异常。它可由多种获得性和先天性因素引起。极少数情况下，它可表现为孤立性慢性中性粒细胞减少症，此时其他血液学细胞系完全正常。本文讨论的病例情况类似，一名29岁女性患者无症状，表现为严重中性粒细胞减少症，而其他细胞系正常。多次进行的实验室检测显示，绝对中性粒细胞计数（ANC）在较长时间内持续严重降低。此外，患者血清免疫球蛋白水平存在一些异常，提示潜在的自身免疫或恶性病变，但这些不足以明确诊断。该患者的独特表现为研究中性粒细胞减少症，尤其是孤立性中性粒细胞减少症的病理成因提供了契机。
