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

Authors

  • Giulia Angelino,

    1. University-Hospital Pediatric Department, Bambino Gesù Children's Hospital IRCCS and University of Rome, ‘Tor Vergata’ School of Medicine, Rome, Italy
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  • Roberta Caruso,

    1. Department of Pediatric Hematology and Oncology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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  • Patrizia D'Argenio,

    1. University-Hospital Pediatric Department, Bambino Gesù Children's Hospital IRCCS and University of Rome, ‘Tor Vergata’ School of Medicine, Rome, Italy
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  • Francesca Ippolita Calò Carducci,

    1. University-Hospital Pediatric Department, Bambino Gesù Children's Hospital IRCCS and University of Rome, ‘Tor Vergata’ School of Medicine, Rome, Italy
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  • Roberto Pascone,

    1. Department of Pediatrics, University of Rome ‘Sapienza’ and Policlinico Umberto I, Rome, Italy
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  • Marina Lanciotti,

    1. Department of Pediatric Hematology and Oncology, Giannina Gaslini Children's Hospital, Genoa, Italy
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  • Caterina Cancrini,

    1. University-Hospital Pediatric Department, Bambino Gesù Children's Hospital IRCCS and University of Rome, ‘Tor Vergata’ School of Medicine, Rome, Italy
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  • Paolo Palma,

    1. University-Hospital Pediatric Department, Bambino Gesù Children's Hospital IRCCS and University of Rome, ‘Tor Vergata’ School of Medicine, Rome, Italy
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  • Alessandro Aiuti,

    1. University-Hospital Pediatric Department, Bambino Gesù Children's Hospital IRCCS and University of Rome, ‘Tor Vergata’ School of Medicine, Rome, Italy
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  • Paolo Rossi,

    1. University-Hospital Pediatric Department, Bambino Gesù Children's Hospital IRCCS and University of Rome, ‘Tor Vergata’ School of Medicine, Rome, Italy
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    • These authors share seniorship.
  • Andrea Finocchi

    Corresponding author
    1. University-Hospital Pediatric Department, Bambino Gesù Children's Hospital IRCCS and University of Rome, ‘Tor Vergata’ School of Medicine, Rome, Italy
    • Correspondence

      Andrea Finocchi, University-Hospital Pediatric Department, Unit of Immunology and Infectious Disease, Bambino Gesù Children's Hospital IRCCS, and University of Rome ‘Tor Vergata’ School of Medicine, Piazza Sant'Onofrio, 4 – 00165 Rome, Italy

      Tel.: +39 06 6859 2935

      Fax: +39 06 6859 2508

      E-mail: andrea.finocchi@uniroma2.it

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    • These authors share seniorship.

Abstract

Background

Neutropenia is not uncommon in childhood. The aim of our study was to analyze the underlying causes of neutropenia and to evaluate its clinical significance in a series of children referred to our center.

Methods

One hundred and four consecutive children with neutropenia were enrolled in this study. Clinical and laboratory features were analyzed.

Results

The majority of patients (63.5%) showed chronic neutropenia. Among all chronic forms, the most frequent was chronic idiopathic neutropenia (CIN), followed by autoimmune neutropenia (AIN). Congenital neutropenia was identified in 6 patients. Acute neutropenia was mainly due to infections.

Overall, at the time of first detection, neutropenia was more frequently severe or moderate. One-third of our patients who presented with severe neutropenia were ultimately diagnosed with a post-infectious acute form. Conversely, nearly half patients with CIN, AIN, or congenital neutropenia showed moderate/mild neutropenia at onset.

Among patients with AIN and CIN, nearly half recovered between 7 months and 46 months and approximately one-fourth experienced infectious episodes during follow-up. No significant difference was noticed in terms of mean ANC between patients with and without remission, neither between patients with and without infections.

Conclusions

Our study confirms the great etiological heterogeneity of neutropenia in children. We could not demonstrate a correlation between ANC level at onset and the underlying disorder, nor a correlation between mean ANC and duration of neutropenia or infectious episodes during follow-up. Neutropenia remains a disease of concern to pediatricians, requiring several laboratory investigations, prolonged follow-up, and, in few cases, advanced molecular methods.

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