MANAGEMENT AND OUTCOMES OF NEUTROPENIA IN PREVIOUSLY HEALTHY CHILDREN

Abstract

Objective: Immun-component children with moderate neutropenia do not have an increased risk for severe bacterial infections. However, there is limited data for the management of benign neutropenia in children. Therefore, we aimed to determine the most common etiology and outcomes in children with neutropenia. In addition, we compare the laboratory findings of different severity levels (neutrophil levels <0.2 × 10³/mL, 0.2 × 10³-0.5 × 10³/mL, 0.5 × 10³- 1 × 10³/mL, 1 × 10³- 1.5 × 10³/mL). Methodology: This retrospective study included children with neutropenia (neutrophil < 1.5 × 10³/mL) diagnosed between December 2019-November 2020 in a tertiary hospital. The patients aged between one month-eighteen year had no history of chronic disease, immunosuppressive therapy, malignancy, or drug administration. Ministry of Health's ethics committee approved the study. We evaluated the etiologies and compared age, sex, time of follow-up, duration of neutropenia, thrombocyte, monocyte and immunglobulin levels of neutrophil levels (<0.2 × 10³/mL, 0.2 × 10³-0.5 × 10³/mL, 0.5 × 10³- 1 × 10³/mL, 1 × 10³- 1.5 × 10³/mL). Results: The most common etiology was acute neutropenia (81.5%) and infections (66%). Five (2.5%) had coronavirus disease. Chronic and autoimmune neutropenia are the most common in chronic neutropenia. Lower neutrophils are associated with prolonged neutropenia (p=0.003), higher monocyte (0.03), higher IgM levels (0.038), younger ages (p<0.001), higher IgG (p=0.002) levels. Sex, time of follow-up, thrombocyte levels, total IgE levels are similar in children with different neutrophil counts. Conclusion: Our study demonstrates the etiology in children with neutropenia. The most common etiology is acute neutropenia with infections. In SARS-CoV2 diseases, neutropenia is less common than other hematologic findings. However, we detected in two point five percent of all. Unknown etiologies are also seen in the acute setting. Immun neutropenia and chronic idiopathic neutropenia are the leading causes of chronic cases. IgM levels were higher than the standard ranges in the agranulocytosis group, with a mean age of 1,05 ± 0,80. Therefore, children with ages of one-two should be carefully checked and followed for immunodeficiencies.