Chronic neutrophilic leukemia is a rare myeloproliferative disorder characterized by a sustained peripheral blood neutrophilia, absence of the BCR/ABL oncoprotein, bone marrow hypercellularity with less than 5% myeloblasts and normal neutrophil maturation, and no dysplasia. This leukemia has been associated with mutations in the colony-stimulating factor 3 receptor that may activate this receptor, leading to the proliferation of neutrophils that are the hallmark of chronic neutrophilic leukemia. We present a case of chronic neutrophilic leukemia and discuss the criteria for diagnosis and the significance of mutations found in this leukemia.

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Combined pulmonary-renal hydralazine-induced vasculitis is rare, and hereditary afibrinogenemia is also rare. We present a case of a 62-year-old man with a history of hereditary afibrinogenemia who presented with hemoptysis and hematuria. Although he had prior episodes of hemoptysis that resolved with repletion of fibrinogen levels, a hydralazine-induced vasculitis was the ultimate cause of his recurrent hemoptysis and hematuria. Hydralazine was held and after transfusion with cryoprecipitate, he was treated with prednisone and rituximab.

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