Neutropenia in childhood: a 15-year experience in a tertiary hospital

Abstract

Objectives. To analyze the clinical forms of presentation, findings at diagnosis, etiological characterization and clinical evolution of different types of neutropenia in childhood,
excluding those associated with diagnosis or oncological treatment.

Material and methods. A retrospective descriptive study of a series of consecutive clinical cases in children diagnosed with neutropenia during the years 2000-2015. Etiological form grouping congenital and acquired types and age groups, were investigated.

Results. Forty-five cases were included, predominantly acquired forms (35, 81.4%). Congenital neutropenia (8, 18.6%) were associated with ethnic neutropenia (3), Fanconi anemia (2) and cyclic neutropenia (3), without other cases of severe congenital neutropenia. The diagnosis of neutropenia was made by casual analytical finding in 20 cases (46.5%) and in 17 (39.5%) by analytic coincidence with infection. The median neutrophils at diagnosis were significantly lower in the primary autoimmune
neutropenia group than in the postinfectious group. In 23 cases (53.5%), neutropenia was persistent. In the congenital forms, the duration of neutropenia and a higher percentage
of recurrent infections were observed. In the acquired cases, the percentage of moderate and severe or very severe neutropenia was higher in the group of children under two
years. The most diagnostic tests were neutrophil antibodies assay (63.3%) and the bone marrow study (41.6%).

Conclusions. Due of the exceptional nature of severe congenital forms, acquired forms of neutropenia predominate in childhood. In these, the greatest severity is associated
with the diagnosis of primary autoimmune neutropenia.