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A rare disorder characterized by recurrent infantile infections and absence of neutrophils in the peripheral blood.
No HPO annotations are available for this condition.
Age of onset: adolescence, childhood, at birth.
Infectious complications are generally more severe in congenital neutropenia than in cyclic neutropenia. In both conditions, individuals have fever and recurrent skin and oropharyngeal inflammation (i.e., mouth ulcers, gingivitis, sinusitis, pharyngitis, and cervical adenopathy). In congenital neutropenia, diarrhea, pneumonia, and deep abscesses in the liver, lung, and subcutaneous tissues are common. Omphalitis immediately after birth may be the first sign . Bacteremia occurs infrequently but has severe consequences in affected individuals. Most congenital neutropenia is diagnosed because of fever and severe infection in infants and young children.
ELANE-related neutropenia represents a clinical spectrum that includes congenital neutropenia, cyclic neutropenia, and intermediate findings between these two phenotypes. Identification of the precise clinical phenotype is helpful for diagnosis, prognosis, and management.
ELANE-related neutropenia should be suspected in individuals with the following clinical and supportive laboratory findings.
Clinical features
• Severe or recurrent infections
No approved treatments are currently available for constitutional neutropenia. The disease remains an area of unmet medical need.
To establish the extent of disease in an individual diagnosed with ELANE-related neutropenia, the following are recommended if they have not already been completed:
Dental examination for gingival and periodontal disease
For those individuals with congenital neutropenia not undergoing HSCT, surveillance for evidence of malignant transformation to MDS/AML is critical to allow early therapeutic intervention. Observation should include the following:
General evaluations by parents and medical personnel several times a year
Blood counts several times a year
7 clinical trials registered, 4 recruiting. Interventions under study include drug therapy, other interventions, medical devices, and biologic therapy. Pipeline includes 1 PHASE3, 2 PHASE2, 1 PHASE1. Research is sponsored by a mix of industry and academic institutions.
NCT ID | Title | Phase | Sponsor | Status |
|---|---|---|---|---|
[NCT06999954](https://clinicaltrials.gov/study/NCT06999954) |
Data assembled from 5 of 12 sources · Last updated Sep 20, 2026, 5:50 AM UTC
European rare disease database
Genetic and Rare Diseases Info Center
Source: GeneReviews — "ELANE-Related Neutropenia"
Congenital neutropenia. Recurrent fevers, sinusitis, gingivitis, and chronic and severe infections in the lung, liver, and soft tissues occurring at irregular intervals
• Cyclic neutropenia
Source: GeneReviews — "ELANE-Related Neutropenia"
The differential diagnosis of congenital neutropenia includes the following disorders.
Isolated neutropenia
Kostmann disease (OMIM 610738), an autosomal recessive form of severe congenital neutropenia caused by biallelic pathogenic variants in HAX1
Note: De novo heterozygous ELANE pathogenic variants (autosomal dominant severe congenital neutropenia) are much more common than HAX1 pathogenic variants (autosomal recessive congenital neutropenia) as a cause of simplex cases of severe congenital neutropenia (i.e., a single occurrence in a family) . For this reason, it is usually best to first sequence ELANE in seeking to determine the genetic basis for severe congenital neutropenia.
Source: GeneReviews — "ELANE-Related Neutropenia"
Biomarker and diagnostic research for constitutional neutropenia has been reported in the published literature.
Evaluation (particularly of those with severe congenital neutropenia) by an otolaryngologist and a pulmonologist for chronic sinopulmonary inflammation and deep abscesses
Evaluation of individuals with severe congenital neutropenia for evidence of myelodysplasia or leukemia with bone marrow aspirate and biopsy
Consultation with a clinical hematologist, geneticist, and/or genetic counselor for specific clinical advice
Fevers require prompt evaluation and empiric treatment until the source of the fever can be definitively identified, at which time targeted treatment may be possible:
Initiation of broad-spectrum antibiotics is important, even lifesaving, when an affected individual has signs of serious infection, which may be caused by either aerobic or anaerobic pathogens. Coverage matching local patterns for infections in immunosuppressed individuals should initially be given for both aerobic and anaerobic organisms.
Granulocyte colony-stimulating factor (G-CSF), given subcutaneously, should also be administered daily starting immediately to promote increased neutrophil production and deployment.
Source: GeneReviews — "ELANE-Related Neutropenia"
Most infections are caused by common organisms on body surfaces including Clostridia species and other anaerobes in the intestinal biota. For this reason it is of little or no benefit to avoid public places.
Source: GeneReviews — "ELANE-Related Neutropenia"
Unrelated cord blood transplantation for neutropenia is being investigated; outcome appears to depend on the closeness of the match . Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for information on clinical studies for a wide range of diseases and conditions.
Source: GeneReviews — "ELANE-Related Neutropenia"
7 trials found
Annual bone marrow cytogenetic studies because of the frequent association of monosomy 7 and malignant transformation
Note: Although sequencing of the receptor for G-CSF (CSF3R) from peripheral blood may also provide evidence of evolution to MDS/AML , its clinical utility is not yet clearly established .
Source: GeneReviews — "ELANE-Related Neutropenia"
Shwachman-Diamond Syndrome Global Patient Survey and Partnering Platform |
— |
Shwachman-Diamond Syndrome Alliance Inc |
UNKNOWN |
[NCT02720679](https://clinicaltrials.gov/study/NCT02720679) | Investigation of the Genetics of Hematologic Diseases | — | St. Jude Children's Research Hospital | RECRUITING |
[NCT06056297](https://clinicaltrials.gov/study/NCT06056297) | A Study of Mavorixafor in Participants With Congenital and Acquired Primary Autoimmune and Idiopathic Chronic Neutropenic Disorders Who Are Experiencing Recurrent and/or Serious Infections | PHASE3 | X4 Pharmaceuticals | RECRUITING |
[NCT04844177](https://clinicaltrials.gov/study/NCT04844177) | Total Lymphoid Irradiation Pre-HSCT in Severe Congenital Neutropenia | PHASE2 | Federal Research Institute of Pediatric Hematology, Oncology and Immunology | UNKNOWN |
[NCT07066085](https://clinicaltrials.gov/study/NCT07066085) | Serial Blood Count Study | EARLY_PHASE1 | University of Washington | RECRUITING |
87 publications have been identified in PubMed for constitutional neutropenia. Research spans Case Report / Case Series (28%), Review / Meta-Analysis (25%), and Basic Science / Preclinical (21%).
Research Type | Count | % of Total |
|---|---|---|
Patient case studies | 24 | 28% |
Research summaries | 22 | 25% |
Laboratory research | 18 | 21% |
Disease patterns and progression | 7 | 8% |
Other research | 6 | 7% |
Testing and diagnosis research | 4 | 5% |
New treatment approaches | 4 | 5% |
Clinical study results | 2 | 2% |
Gilbert JS (2026). [PMID: 40199260](https://pubmed.ncbi.nlm.nih.gov/40199260/). *Acta Haematol*. [Review / Meta-Analysis]
Wang Z (2026). [PMID: 42056350](https://pubmed.ncbi.nlm.nih.gov/42056350/). *Mol Genet Genomic Med*. [Case Report / Case Series]
Miyamoto R (2026). [PMID: 41485978](https://pubmed.ncbi.nlm.nih.gov/41485978/). *J Vet Med Sci*. [Case Report / Case Series]
Borg Azzopardi D (2026). [PMID: 41638760](https://pubmed.ncbi.nlm.nih.gov/41638760/). *BMJ Case Rep*. [Case Report / Case Series]
Pantea CL (2026). [PMID: 41751872](https://pubmed.ncbi.nlm.nih.gov/41751872/). *Int J Mol Sci*. [Basic Science / Preclinical]
Albar RF (2026). [PMID: 41613507](https://pubmed.ncbi.nlm.nih.gov/41613507/). *Cureus*. [Case Report / Case Series]
Gao J (2026). [PMID: 41526335](https://pubmed.ncbi.nlm.nih.gov/41526335/). *Cell Death Dis*. [Basic Science / Preclinical]
Wakula M (2026). [PMID: 42086536](https://pubmed.ncbi.nlm.nih.gov/42086536/). *Cell Death Dis*. [Basic Science / Preclinical]
Chetruengchai W (2026). [PMID: 41881056](https://pubmed.ncbi.nlm.nih.gov/41881056/). *Eur J Dent*. [Review / Meta-Analysis]
Roveta A (2026). [PMID: 41657465](https://pubmed.ncbi.nlm.nih.gov/41657465/). *EJHaem*. [Other]