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- $Unique_ID{BRK04050}
- $Pretitle{}
- $Title{Neutropenia, Cyclic}
- $Subject{Neutropenia, Cyclic CN Human Cyclic Neutropenia Periodic Neutropenia
- Cyclic Hematopoiesis Severe Infections Leukemia}
- $Volume{}
- $Log{}
-
- Copyright (C) 1989, 1992 National Organization for Rare Disorders, Inc.
-
- 663:
- Neutropenia, Cyclic
-
- ** IMPORTANT **
- It is possible that the main title of the article (Cyclic Neutropenia) is
- not the name you expected. Please check the SYNONYM listing to find the
- alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- CN
- Human Cyclic Neutropenia
- Periodic Neutropenia
- Cyclic Hematopoiesis
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Severe Infections
- Leukemia
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
- Cyclic Neutropenia is a rare blood disorder characterized by an abnormal
- low number of a type of white blood cells called neutrophils that occur
- periodically in patients with this disorder. Recurrent infections with fever
- usually occur as a result of this imbalance in the blood.
-
- Symptoms
-
- The severe decrease in neutrophils recurs every 15 to 35 days in Cyclic
- Neutropenia. The cycling period usually remains constant and consistent
- among patients. Cycling of platelets and immature red blood cells
- (reticulocytes) may also occur. Abnormal increases of monocytes (a type of
- white blood cell) and eosinophils (a type of white blood cell) may also
- occur. Thrombocytopenia, a severe decrease in platelets (clotting factor in
- the white blood cells) may also be present.
-
- Infections usually accompany the cycling neutropenia. Ulcerous,
- inflammatory diseases of the mouth (aphthous stomatitis) may occur. If the
- duration of the neutropenia is long, inflammation of the salivary (parotid)
- gland in the mouth may also occur. Swollen lymph nodes in the neck (cervical
- adenopathy), skin infections, and dental problems may also be present.
- Fever, tiredness, and weakness is common.
-
- In childhood Cyclic Neutropenia, symptoms begin in infancy or childhood
- and tend to improve as the patient grows older.
-
- Causes
-
- Cyclic Neutropenia is usually inherited as an autosomal dominant trait in
- children; however, it is an acquired disorder in adults and the cause is
- unknown. Research suggests the cyclic decreases in neutrophils may be due to
- white blood cells that do not mature properly in the bone marrow.
-
- Human traits including the classic genetic diseases, are the product of
- the interaction of two genes for that condition, one received from the father
- and one from the mother. In dominant disorders a single copy of the disease
- gene (received from either the mother or father) will be expressed
- "dominating" the other normal gene and resulting in appearance of the
- disease. The risk of transmitting the disorder from affected parent to
- offspring is fifty percent for each pregnancy regardless of the sex of the
- resulting child.
-
- Affected Population
-
- Cyclic Neutropenia occurs worldwide and affects males and females in equal
- numbers. In about one-fourth of the cases, a family history of Cyclic
- Neutropenia can be found.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Cyclic
- Neutropenia. Comparisons may be useful for a differential diagnosis:
-
- Neutropenia may occur as a result of severe infections. Fever,
- tiredness, weakness, headache, muscle pain, and loss of appetite are common
- symptoms. The factor that distinguishes Cyclic Neutropenia from other types
- of neutropenia is its regular periodic occurrence.
-
- Leukemia is a group of rare malignant cancers affecting children and
- adults. It is characterized by the increased production and survival of
- abnormal, immature white blood cells (leukocytes) which eventually interferes
- with the production and function of normal, mature white blood cells
- (granulocytes). Platelets (clotting cells of the blood) and red blood cells
- may also be affected. Symptoms may include swollen lymph nodes, enlarged
- spleen and liver, fever, weight loss, paleness, fatigue, easy bruising,
- excessive bleeding (for example, from the nose and gums), and repeated
- infections.
-
- Pain, especially in the joints, and skin disorders may also occur. The
- exact cause of Leukemia is unknown. (For more information on a rare form
- Leukemia, choose "Leukemia" as your search term in the Rare Disease
- Database.)
-
- Therapies: Standard
-
- Treatment of the infections associated with Cyclic Neutropenia with
- antibiotics is important. Careful oral and dental care is required.
-
- Corticosteroids are drugs commonly used for treating Cyclic Neutropenia.
- These drugs, such as prednisone and prednisolone, may relieve inflammation
- and suppress the immune system.
-
- The drug lithium carbonate may increase neutrophil production; however,
- long-term use may lead to complications. This drug should be used with
- extreme caution.
-
- The drug etiocholanolone may be effective in treating Cyclic Neutropenia.
-
- Genetic counseling may be of benefit for patients with the inherited form
- of Cyclic Neutropenia and their families. Other treatment is symptomatic and
- supportive.
-
- Therapies: Investigational
-
- Plasmapheresis may be of benefit in some cases of Cyclic Neutropenia. This
- procedure is a method for removing unwanted substances (toxins, metabolic
- substances and plasma parts) from the blood. Blood is removed from the
- patient and blood cells are separated from plasma. The patient's plasma is
- then replaced with other human plasma and the blood is retransfused into the
- patient. This therapy is still under investigation to analyze side effects
- and effectiveness. More research is needed before plasmapheresis can be
- recommended for use in all but the most severe cases of Cyclic Neutropenia.
-
- In other studies, scientists are investigating the use of recombinant
- growth factor Granulocyte Stimulating Factor (G-CSF) in treatment of Cyclic
- Neutropenia. Patients treated with G-CSF appear to have a decrease in
- symptoms, but more research is neeed to determine the long-term safety and
- effectiveness on patients with Cyclic Neutropenia.
-
- This disease entry is based upon medical information available through
- November 1992. Since NORD's resources are limited, it is not possible to
- keep every entry in the Rare Disease Database completely current and
- accurate. Please check with the agencies listed in the Resources section for
- the most current information about this disorder.
-
- Resources
-
- For more information on Cyclic Neutropenia, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- NIH/National Heart, Blood & Lung Institute
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-4236
-
- For genetic information and genetic counseling referrals for the
- inherited form of Cyclic Neutropenia:
-
- March of Dimes Birth Defects Foundation
- 1275 Mamaroneck Avenue
- White Plains, NY 10605
- (914) 428-7100
-
- Alliance of Genetic Support Groups
- 35 Wisconsin Circle, Suite 440
- Chevy Chase, MD 20815
- (800) 336-GENE
- (301) 652-5553
-
- References
-
- MENDELIAN INHERITANCE IN MAN, 7th ed.: Victor A. McKusick; Johns Hopkins
- University Press, 1986. Pp. 529.
-
- HUMAN CYCLIC NEUTROPENIA: CLINICAL REVIEW AND LONG-TERM FOLLOW-UP OF
- PATIENTS: D.G. Wright, et al.; Medicine (Baltimore) (January, 1981: issue
- 60(1)). Pp. 1-13.
-
- CYCLIC HEMATOPOIESIS: HUMAN CYCLIC NEUTROPENIA: R.D. Lange; Exp Hematol
- (July, 1983: issue 11(6)). Pp. 435-451.
-
- ADULT-ONSET CYCLIC NEUTROPENIA IS A BENIGN NEOPLASM ASSOCIATED WITH
- CLONAL PROLIFERATION OF LARGE GRANULAR LYMPHOCYTES: T.P. Loughran, Jr. &
- W.P. Hammond, 4th; J Exp Med (December 1, 1986: issue 164(6)). Pp. 2089-
- 2094.
-
-