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Neutropenia With Narrow Hyperplasia

Sean O'Regan, MB, BCh; Arthur J. Newman, MD; Richard C. Graham, MD

Am J Dis Child. 1977;131(6):655-658.

Abstract
• A 10-year-old girl was first seen at age 5 years with pneumonia and neutropenia. Since then, she has remained leukopenic, although manifesting a leukocytosis only when she has pulmonary infection. A rapid fall in her peripheral WBC count occurs with initiation of antibiotic therapy. Despite her neutropenia, marked myeloid hyperplasia is evident on marrow smear examination; many cells being hypersegmented with fine intralobular bridging with chromatin strands and cytoplasmic vacuolation. The peripheral WBC response to epinephrine administration did not indicate a shift from the circulating to marginal neutrophil pool. Results from a Rebuck skin window test suggested poor neutrophil tissue migration. A defect in granulocyte release from the patient's marrow may explain these bizarre hematologic findings.

(Am J Dis Child 131:655-658, 1977)

Author Affiliations
From the Department of Pediatrics and Medicine, Case Western University School of Medicine, Cleveland.

Footnotes
Reprint requests to Montreal Children's Hospital, 2300 Tupper St, Montreal, Quebec H3H 1Ps, Canada (Dr O'Regan).

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