Incidental Chronic Neutropenia in an Asymptomatic Adult

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.