About DANIL HAMMOUDI.MD Expertise answer all questions regarding this condition, treatment options and prevenbtion if any
Experience general surgery, expert to several web site and categories, answer about 300 crohn's disease question a month and practical experience for more than 4 years
Question Hi
BACKGROUND: I am a 25 year old female. I have crohn's disease. I was diagnosed after an initial mild flare-up about three years ago. Since then I have had no symptoms. I commenced medication and had blood tests while I was on the tablets. I was then diagnosed with cyclical neutropenia. As a result, I was taken off my tablets – in case the crohn's medication was causing the neutropenia. The doctors are not 100% sure of the cause of the neutropenia. I am not taking any crohn's medication. I take 150mg of Efexor xl daily and the pill.
QUESTION: I intermittently go through short periods of night sweats. The sweating is quite strong and only occurs in my legs. I think this may be related to a flare up of crohns. Perhaps I am wrong in assuming this. While I have the sweats I have no other symptoms and feel generally healthy.
I would really appreciate your help.
Eve.
Answer since you had or have neutropenia [I do not know if it is real cyclic type or not since Autosomal dominant disorder of children and young adults characterized by cyclical neutropenia, producing fever, malaise, mouth ulcers and cervical lymphadenopathy. Usual course - relapsing; 21-day cycles.] but check for an infection that might explain these sweating in the same time check for tuberculosis and sarcoidosis. You need to take your temperatures anf check your veins status.
it can be related to crohn's but ittouch specifically the articulations.Check for Shwachman-Diamond Syndrome i doubt it is your case since the manifestation are during the childhood but since I do not know the fulll story it is a suggestion.
Neutropenia can be caused by medication but the question is if you did not have it before hand, even before the croh's started with an an infetion viral or tb type.
Cyclic neutropenia is another inherited type of neutropenia. As the name indicates, in this disease neutrophil counts show a cyclic pattern with a typical cycle length of 21 days. These cycles vary from patient to patient with some individuals being neutropenic during the whole cycle and others who have low neutrophil counts for only a few days and normal blood counts during the rest of the cycle. The frequency of bacterial infections depends on the length of the neutropenic period that the patient experiences. Those who have a longer neutropenic period within the cycle suffer more frequently from infections compared to patients who have only short neutropenic phases.
If infections (typically aphthous stomatitis - inflammation and ulceration of the mouth) occur frequently in approximately 3-week intervals, cyclic neutropenia should be considered and serial differential blood counts need to be performed (at least 3 times per week over six weeks) to search for the typical cyclical pattern of blood neutrophils in this disease.
Almost all patients with clinically obvious cyclic neutropenia have periods of severe neutropenia (ANC less than 200 cells/µl) (0.2 x 109/l) every 3 weeks showing some symptoms with almost every cycle, but significant infections (e.g. otitis media, pneumonia and bacteraemia) usually are infrequent. Cyclic neutropenia occurs because of fluctuating rates of cell production by the bone marrow stem cells. In contrast to other causes for neutropenia, in this condition the marrow changes during the cycle, between normal appearance and that of severe maturation arrest of neutrophil production. The underlying genetic defect of cyclic neutropenia has recently been discovered. This might lead to new therapeutical approaches for cyclic neutropenia patients in the future.
Other blood cells, such as platelets or red cells can also show oscillations with a cyclical pattern. Cyclic neutropenia can occur sporadically, but there are families in which cyclic neutropenia is inherited with one parent and more than one child affected. As in Kostmann syndrome, patients with cyclic neutropenia also benefit from G-CSF treatment.
but overall I think that you should see an hematologist and have a full assessment on your neutropenia, I have some doubt on a cyclic type but a temporarely may be.
