Primary splenic neutropenia--revisited.

A patient with acquired, isolated, chronic, severe neutropenia, minimal splenomegaly, and myeloid hyperplasia in the bone marrow is described. Splenectomy resulted in a rise into the normal range of the absolute neutrophil count within 18 hours after ligation of the splenic artery. No other underlying disorders were found, and efforts to demonstrate antineutrophilic autoantibodies before and after splenectomy were unsuccessful. Although this case might be referred to as "primary splenic neutropenia," it is likely that the basic abnormality was intrinsic to the neutrophil. Such cases should be designated "idiopathic neutropenia," since no primary disorder of the spleen can be demonstrated.