A case of cyclic neutropenia in adults

A 22 years old patient presented with recurrent episodes of diarrhoea, pharyngitis, apthous ulcers and fever for the past 6 months. the episodes lasted a week each time. the patient was admitted and blood studies revealed neutropenia with increased number of large granular lymphocytes. later on it was found out that his neutrophil count dropped to less than 0.2 x 10^9/l after every 3 weeks. bone marrow study revealed decreases neutrophil precursors during these episodes. he was diagnosed with adult onset cyclic neutropenia and his episodes were treated with g-csf and ceftriaxone.