[Cyclic agranulocytosis (author's transl)]

Area of Science:

• Pediatric Hematology
• Immunology
• Infectious Diseases

Context:

• Cyclic agranulocytosis is a rare disorder characterized by periodic severe drops in neutrophil counts.
• This condition often presents with recurrent infections, fever, stomatitis, and sore throat.
• Early diagnosis and intervention are crucial for managing cyclic neutropenia.

Purpose:

• To report a case of cyclic agranulocytosis in a pediatric patient.
• To evaluate the efficacy of prophylactic tetracycline treatment in preventing symptomatic episodes.
• To highlight the importance of timely intervention in managing cyclic neutropenia.

Summary:

• A 10.5-year-old girl experienced cyclic agranulocytosis with symptoms including stomatitis, sore throat, and fever every ~3 weeks since 6 months of age.
• Prophylactic oral tetracycline was initiated 2 days before expected neutrophil decline.
• The patient remained clinically asymptomatic for 7 months with this treatment regimen.

Impact:

• This case demonstrates that prophylactic tetracycline can effectively prevent symptomatic episodes of cyclic agranulocytosis in children.
• Early and consistent prophylactic treatment can significantly improve the quality of life for patients with cyclic neutropenia.
• The findings support the use of prophylactic antibiotics as a management strategy for cyclic neutropenia.