Large Granular Lymphocytic Leukemia and Cocaine Abuse in A Patient With Chronic Neutropenia - Are They Co-Existing or Causally Related?

Chronic neutropenia is a hematological condition that could cause significant morbidity due to recurrent infections. Various benign and malignant disorders manifest with chronic neutropenia and a meticulous evaluation is needed. Complex interplay of several mechanisms could lead to neutropenia in the same patient. Hence it is important to understand the disease biology. Substances with abuse potential like cocaine are thought to cause immune mediated destruction of neutrophils. For disorders like large granular lymphocytic leukemia which arises from chronic antigenic stimulation, it is unclear whether agents like cocaine are potential triggering factors. The given case involves a patient with chronic neutropenia for which a complex interplay of cocaine abuse and large granular lymphocytic leukemia is postulated to be responsible for the clinical manifestation, enhancing the insight about the disease pathogenesis.