Abstract
BackgroundSevere congenital neutropenia (SCN) is an immunodeficiency disease characterized low blood neutrophil counts, early bacterial infections, and risk of leukaemia development. Heterozygous mutations in the ELANE gene coding neutrophil elastase are associated with SCN. Patients with SCN suffer from recurrent bacterial infections and often succumb them. To our knowledge, this is the first report of SCN from Vietnam.Case presentationA 6-year-old boy was admitted due to severe bacterial infection and severe neutropenia. He had recurrent infections from 8 months of age, and was misdiagnosed with tuberculosis and and autoimmune neutropenia in infancy at 21 and 41 months of age, respectively. His medical report has showed severe neutropenia for many times. In direct DNA sequencing analysis, we found an ELANE gene mutation (R81P), which had been confirmed to cause SCN.ConclusionThe missed and delayed diagnosis may be attributable to insufficient awareness of this rare disease on the background of frequent infections even in the immunocompetent pediatric population in Vietnam. Our results indicate further evidence for the role of ELANE in SCN.
Highlights
Severe congenital neutropenia (SCN) is an immunodeficiency disease characterized low blood neutrophil counts, early bacterial infections, and risk of leukaemia development
SCN is a very rare condition that is diagnosed when absolute neutrophil count (ANC) is less than 0.5 × 109/L for at least three months
The diagnosis was missed and delayed until six years of age. This issue can be explained by some reasons: Vietnam is a tropical country where infectious diseases are very popular and there is an insufficient awareness of this rare disease on the background of frequent infections even in immunocompetent pediatric population [6]
Summary
The missed and delayed diagnosis may be attributable to insufficient awareness of this rare disease on the background of frequent infections even in the immunocompetent pediatric population in Vietnam. Our results indicate further evidence for the role of ELANE in SCN. Keywords: Congenital severe neutropenia, ELANE, Severe bacterial infection, Autoimmune neutropenia
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