R.S.
I am a pediatrician. The diagnosis of cyclic neutropenia is sort of made retrospectively. If it is suspected, the child should get their blood drawn weekly to look at the white blood cell counts (WBC's). Over time, one can get a pattern of how the counts fluctuate (or "cycle" from high to low). Often the WBC's dip every 3 weeks or so. Because in kids, there are many things that cause these numbers to fluctuate, it can be a difficult diagnosis to make and it is often a diagnosis of exclusion -- that is, other things that are much more serious, such as cancers, sometimes have to be ruled out. In addition, clinical symptoms can point to cyclic neutropenia, such as a child who gets ill around the same time every month. By illness, that does not always mean the child is very sick; on the contrary, the child can be simply a little sniffly, have fever for a day or two, or get apthous ulcers (fever blisters) that come and go regularly. So fortunately, in most cases it is not a terribly dangerous diagnosis, since the WBC count rarely gets so low that the child is at risk for very serious infections (but please note that there IS a risk of serious infection, higher than the general population, even though it is low). Some people have no symtoms and live normal lives without ever knowing they even have the condition. As children age, the WBC's either don't cycle anymore or stay chronically on the low side of normal. If they are on the low side of normal, this may mean that they are still healthy like everyone else or get sick a little more often than others.
