Etiology, clinical outcome, and laboratory features in children with neutropenia: analysis of 104 cases

摘要

Neutropenia is not uncommon in childhood. The aim of our study was toudanalyze the underlying causes of neutropenia and to evaluate its clinical significance inuda series of children referred to our center.udMethods: One hundred and four consecutive children with neutropenia were enrolledudin this study. Clinical and laboratory features were analyzed.udResults: The majority of patients (63.5%) showed chronic neutropenia. Among alludchronic forms, the most frequent was chronic idiopathic neutropenia (CIN), followedudby autoimmune neutropenia (AIN). Congenital neutropenia was identified in 6udpatients. Acute neutropenia was mainly due to infections.Overall, at the time of firstuddetection, neutropenia was more frequently severe or moderate. One-third of ourudpatients who presented with severe neutropenia were ultimately diagnosed with a postinfectiousudacute form. Conversely, nearly half patients with CIN, AIN, or congenitaludneutropenia showed moderate/mild neutropenia at onset.Among patients with AINudand CIN, nearly half recovered between 7 months and 46 months and approximatelyudone-fourth experienced infectious episodes during follow-up. No significant differenceudwas noticed in terms of mean ANC between patients with and without remission,udneither between patients with and without infections.udConclusions: Our study confirms the great etiological heterogeneity of neutropenia inudchildren. We could not demonstrate a correlation between ANC level at onset and theudunderlying disorder, nor a correlation between mean ANC and duration ofudneutropenia or infectious episodes during follow-up. Neutropenia remains a diseaseof concern to pediatricians, requiring several laboratory investigations, prolongedfollow-up, and, in few cases, advanced molecular methods.