Term delivery in a woman with severe congenital neutropenia, treated with growth colony stimulating factor

The patient was diagnosed in childhood as having severe congenitalneutropenia and had recurrent admissions with severe infections. In 1987,prior to getting married, she was sterilized. She continued to require i.v.antibiotics when she contracted a severe infection. On one occasion, shewas treated with growth colony stimulating factor (G- CSF). Her increasedneutrophil count was sustained following this treatment. In June 1993, shewished to start a family and underwent in- vitro fertilization (IVF)treatment. G-CSF was given prior to oocyte retrieval. She conceived on herfirst cycle and an ultrasound scan revealed a singleton pregnancy.Throughout the course of the pregnancy, her white cell count was monitoredclosely and remained at <1.0x10(9)/l. The pregnancy progresseduneventfully and at 37 weeks gestation she was admitted for G-CSFinjections. At 38 weeks she was delivered of a boy weighing 3350 g, byelective Caesarean section. His white cell count was normal. This is thefirst case of G-CSF being used before conception and during pregnancy in apatient with congenital neutropenia. It shows that advances in cytokinetherapy and close interdisciplinary liaison can lead to a successfuloutcome and help patients, who would otherwise remain childless, to achievea family.