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Chronic Idiopathic Neutropenia Treatment With Corticosteroids and Mercaptopurine

Allan Lipton, MD
Arch Intern Med. 1969;123(6):694-700. doi:10.1001/archinte.1969.00300160084014.
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Abnormalities in the circulating.neutrophil level may be acute or chronic. Neutropenia may result from decreased neutrophil production in the marrow,1,2 inability of viable cells to leave the site of synthesis,3 or increased rate of destruction of granulocytes after they leave the bone marrow.4

Fitz-Hugh and Krumbhaar 5 suggested a classification of the chronic, noncyclic, nonfamilial neutropenias on the basis of bone marrow morphology. Spaet and Dameshek 6 reported four patients with chronic neutropenia with a selective hypoplasia of the granulocytic series in the bone marrow. This disorder is characterized as follows: a chronic course, repeated infections, slight splenomegaly, and persistent noncyclic neutropenia. Splenectomy failed to alter the course of the disease in three of these patients. Hickie 7 and Librach8 also reported individual patients with selective hypoplasia of all marrow granulocytic elements. Fitz-Hugh and Krumbharr5 reported a case of chronic neutropenia in which the cellular


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