Abstract
Background: Congenital neutropenia is a primary immunodeficiency characterized by a low neutrophil count, which predisposes to recurrent infections. A mutation in the ELANE gene is the most common cause of this disorder.
Case report: A 3-month-old infant with a history of recurrent bacterial infections since birth. The patient had presented with omphalitis and preseptal cellulitis, associated with a low blood neutrophil count. Suspecting congenital neutropenia, a genetic panel was performed, identifying a pathogenic mutation in the ELANE gene (c.164G>A, p.Cys55Tyr). Treatment with granulocyte colony-stimulating factor (G-CSF) was initiated, resulting in a significant improvement in the neutrophil count and resolution of the recurrent infections. The patient showed significant clinical improvement and is currently on a therapeutic protocol and receiving regular follow-up.
Conclusion: This case illustrates the importance of early diagnosis of congenital neutropenia. In every case where a pediatric patient with recurrent and difficult-to-manage bacterial infections is studied.
Keywords: Congenital neutropenia; Neutrophils; ELANE mutation; Cellulitis; Granulocyte colony-stimulating factor; Early diagnosis.
References
1. Lehman KH, Segal BH. The role of neutrophils in host defense and disease. J Allergy Clin Immunol 2020; 145 (6): 1535-44. https://doi.org/10.1016/j.jaci.2020.02.038
2. Mickey D, Valdes-Camacho J, Khan A, Kaufman D. Immunodeficiency: Quantitative and qualitative phagocytic cell defects. Allergy Asthma Proc 2024; 45: 299-304. https://doi.org/10.2500/aap.2024.45.240049
3. Spoor J, Farajifard H, Rezaei N. Congenital neutropenia and primary immunodeficiency diseases. Crit Rev Oncol Hematol 2019; 135: 173-84. https://doi.org/10.1016/j.critrevonc.2018.10.003
4. Guzman-Cotaya R, Baeza-Bastarrachea R, Espinosa-Padilla SE. Neutropenia congénita. Alergia, Asma e Inmunología 1998; 30 (1): 24-7. https://dx.doi.org/10.35366/100114
5. Hauck F, Klein C. Pathogenic mechanisms and clinical implications of congenital neutropenia syndromes. Curr Opin Allergy Clin Immunol 2013; 13 (6): 613-21. https://doi.org/10.1097/ACI.0000000000000014
6. Skokowa J, Dale DC, Touw IP, Zeidler C, et al. Severe congenital neutropenias. Nat Rev Dis Primers 2018; 4: 26. https://doi.org/10.1038/nrdp.2017.32
7. Wang J, Zhang H, Wang Y, Liang L, et al. Severe congenital neutropenia caused by ELANE gene mutation: A case report and literature review. Medicine (Baltimore) 2022; 101 (2): e31357. https://doi.org/10.1097/MD.0000000000031357
8. Arun AK, Senthamizhselvi A, Hemamalini S. Spectrum of ELANE mutations in congenital neutropenia: a single-centre study in patients of Indian origin. J Clin Pathol 2018; 71 (11): 1046-50. https://doi.org/10.1136/jclinpath-2018-205235
9. Vaca CL, Hidalgo JL. Agammaglobulinemia ligada al cromo- soma X, lo crucial del diagnóstico y tratamiento oportunos. Cambios Rev Méd 2019; 18 (1): 90-95. https://doi.org/10.36015/cambios.v18.n1.2019.395

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