Advertisement

Clinical Profile and Short Term Outcome of Children with Neutropenia

  • Akanksha MahajanEmail author
  • Virendra Kumar
  • Sangeeta Pahuja Sindhwani
  • Viswas Chhapola
Original Article

Abstract

Objectives

To study the clinical profile and short term outcome of neutropenia in children during hospital stay.

Methods

An observational study was carried out at a Children’s Hospital. The study population comprised of 77 admitted children aged 1 mo to 18 y with a varied clinical profile and neutropenia; defined as absolute neutrophil count less than 1500/mm3. Patients known to have HIV, immunodeficiency, malignancy, aplastic anemia or chronic systemic illness were not enrolled. Necessary investigations were done to identify etiology as per clinical features. They were treated and followed up for a period of 4 wk or discharge; whichever was earlier. The primary outcome of duration of neutropenia and secondary outcomes of hospital stay duration, association with thrombocytopenia, incidence of complications and finally discharge/death were analyzed.

Results

Acute transient neutropenia was seen, the median duration being 3 d in younger patients. Dengue fever was the commonest etiology. The median duration of hospital stay was 8 d. Fifty three (68.8%) patients had associated thrombocytopenia. Three children developed complications like nosocomial sepsis and shock. Seventy two (93.5%) were discharged, 1 died, 3 left against medical advice and one patient was followed up for 4 wk.

Conclusions

Acute febrile illnesses like dengue, enteric fever, malaria are the predominant causes of neutropenia. Mild neutropenia was seen in over 50% children requiring a short duration of admission (5–8 d); without any complications.

Keywords

Neutropenia Non malignant Febrile illness Dengue 

Notes

Authors’ Contribution

AM: Collected the data and wrote the paper. VK and SPS: Guided the study, contributed to diagnosis and hematological investigations respectively. VC: Helped in data interpretation and analysis. VK is the guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

None.

References

  1. 1.
    Celkan T, Koç BS. Approach to the patient with neutropenia in childhood. Turk Pediatri Ars. 2015;50:136–44.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Denic S, Narchi H, Al Mekaini LA, Al-Hammadi S, Al Jabri ON, Souid A-K. Prevalence of neutropenia in children by nationality. BMC Hematol. 2016;16:15.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Joshi AA, Gayathri BR, Muneer F. Dynamics of differential count in dengue. Int J Adv Med. 2018;5:145–50.CrossRefGoogle Scholar
  4. 4.
    Thein TL, Lye DC, Leo YS, Wong JG, Hao Y, Wilder-Smith A. Short report: Severe neutropenia in dengue patients: prevalence and significance. Am J Trop Med Hyg. 2014;90:984–7.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Gaudichon J, Cornet E, Minckes O, Bodet D. Fortuitously discovered neutropenia in children: diagnosis and follow-up. Arch Pediatr. 2015;22:822–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Husain EH, Mullah-Ali A, Al-Sharidah S, Azab AF, Adekile A. Infectious etiologies of transient neutropenia in previously healthy children. Pediatr Infect Dis J. 2012;31:575–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Kim DH, Lee JH, Yoon HS. Clinical course of neutropenia in previously healthy children. Clin Pediatr Hematol Oncol. 2018;25:87–96.CrossRefGoogle Scholar
  8. 8.
    Braden CD, Talavera F, Besa EC. Neutropenia. Medscape Hematol. Sept 2018. Available at: https://emedicine.medscape.com/article/204821-overview#a12. Accessed 10 Feb 2019.
  9. 9.
    Pascual C, Trenchs V, Hernández-Bou S, Català A, Valls AF, Luaces C. Outcomes and infectious etiologies of febrile neutropenia in non-immunocompromised children who present in an emergency department. Eur J Clin Microbiol Infect Dis. 2016;35:1667–72.CrossRefPubMedGoogle Scholar
  10. 10.
    Karavanaki K, Polychronopoulou S, Giannaki M, et al. Transient and chronic neutropenias detected in children with different viral and bacterial infections. Acta Paediatr. 2006;95:565–72.CrossRefPubMedGoogle Scholar
  11. 11.
    Sung L, Johnston D. Approach to febrile neutropenia in the general paediatric setting. Paediatr Child Health. 2007;12:19–21.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Chen CH, Huang YC, Kuo KC, Li CC. Clinical features and dynamic ordinary laboratory tests differentiating dengue fever from other febrile illness in children. J Microbiol Immunol Infect. 2018;51:614–20.CrossRefPubMedGoogle Scholar
  13. 13.
    Patel K, Patel D, Das VK. Parameters and its utility in dengue fever: a prospective study. Int J Sci Res (IJSR). 2016;5:1077–9.Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  1. 1.Department of PediatricsLady Hardinge Medical College and associated Kalawati Saran Children’s HospitalNew DelhiIndia
  2. 2.Department of PathologyLady Hardinge Medical CollegeNew DelhiIndia

Personalised recommendations