Case 1 immunologic studies, which showed transient lowered levels of IgG and IgA and neutropenia. Bone marrow analysis confirmed the neutropenia without any other abnormalities. Plasma and urine amino acids profile, urine organic acids, free and acylcarnitine and plasma very long chain fatty acids profile, blood lactate/pyruvate ratio, urine NAG/creatinine ratio, purine metabolisms, thyroid hormone analysis all gavenormal results. Here, TG is linked to neutropenia.