Colon ulceration and perforation in Cyclic Neutropenia

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Abstract

Cyclic Neutropenia is a rare hematologic disease in which regular episodes of severe neutropenia, usually accompanied by fever, mucous membrane ulceration, and abdominal pain and tenderness, recur at approximately 3-wk intervals.1,2 A patient with this disease, who developed localized colon necrosis, peritonitis, and clostridial septicemia during a neutropenic period, was treated recently. Exteriorization of the colon prior to perforation allowed for staged elective resection subsequently and provided a unique opportunity to observe the cyclic formation of mucosal ulcerations in the large bowel. Although cyclic neutropenia is rarely accompanied by life-threatening infection, this case serves to emphasize the potential severity of such a complication. Furthermore, abdominal pain, should it occur, merits careful observation since unrecognized colon necrosis has been the cause of death in previously reported cases of this disease.4,5

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Cited by (0)

1

Admitting Officer, National Cancer Institute, Bethesda, Md.

2

Senior Staff Fellow, Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, Bethesda, Md.

3

Senior Investigator, Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, Bethesda, Md.

4

Senior Investigator, Surgery Branch, National Cancer Institute, Bethesda, Md.

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