title: Etiology, clinical outcome, and laboratory features in children with neutropenia: analysis of 104 cases.
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.
authors: University-Hospital Pediatric Department, Bambino Gesù Children's Hospital IRCCS and University of Rome, 'Tor Vergata' School of Medicine, Rome, Italy.
authors: Giulia
authors: G
authors: Angelino
authors: Roberta
authors: R
authors: Caruso
authors: Patrizia
authors: P
authors: D'Argenio
authors: Francesca Ippolita
authors: FI
authors: Calò Carducci
authors: Roberto
authors: R
authors: Pascone
authors: Marina
authors: M
authors: Lanciotti
authors: Caterina
authors: C
authors: Cancrini
authors: Paolo
authors: P
authors: Palma
authors: Alessandro
authors: A
authors: Aiuti
authors: Paolo
authors: P
authors: Rossi
authors: Andrea
authors: A
authors: Finocchi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009503:Neutropenia / Q000151:congenital / Q000175:diagnosis / Q000209:etiology*
keywords: acute neutropenia; autoimmune neutropenia; children; chronic idiopathic neutropenia; congenital neutropenia; post-infectious neutropenia; severe congenital neutropenia