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August 1989, Vol 143, No. 8 >
Article | August 1989

Risk of Infectious Complications in Well-Appearing Children With Transient Neutropenia FREE

Anthony J. Alario, MD; John S. O'Shea, MD
[+] Author Affiliations

Accepted for publication March 3, 1989.

Read in part at the 57th Annual Meeting of the Society for Pediatric Research, Washington, DC, May 5, 1988.

Reprint requests to Division of Ambulatory Pediatrics, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903 (Dr Alario).


Am J Dis Child. 1989;143(8):973-976. doi:10.1001/archpedi.1989.02150200135033.
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References
Comments

• To determine whether well-appearing children found incidentally to be neutropenic are at risk for an infectious complication, 44 consecutive months of hematology laboratory records were reviewed. One hundred nineteen patients had medical record documentation regarding clinical course, serial white blood cell counts, and the absence of serious infections, chronic illnesses, or a family history known to be associated with neutropenia. The median duration of documented neutropenia was 13 days (range, 1 to 491 days). Infectious complications occurred in 4 of the 36 patients who had neutropenia for more than 30 days (2 with stomatitis, 1 with cellulitis, and 1 with pneumonia) but in none with shorter durations of neutropenia. There were no significant associations between the development of an infectious complication and either the initial absolute neutrophil count or the lowest documented absolute neutrophil count, nor was there a correlation between the initial absolute neutrophil count and the duration of neutropenia. These data indicate that infectious complications occur in otherwise well children with unexplained neutropenia that persists, but these infections are infrequent and usually are superficial.

(AJDC. 1989;143:973-976)

REFERENCES

1 +
Feigin RD, Matson DO.  Opportunistic infections . In: Feigin RD, Cherry JD, eds. Textbook of Pediatric Infectious Diseases . 2nd ed. Philadelphia, Pa: WB Saunders Co; 1987;:1018.
2 +
Joshi JH, Schimpff SC.  Infections in the compromised host . In: Mandell GL, Douglas RG, Bennett JE, eds. Principles and Practice of Infectious Diseases . 2nd ed. New York, NY: John Wiley & Sons Inc; 1985;:1645-1646.
3 +
Pincus SH, Boxer LA, Stossel TP.  Chronic neutropenia in childhood . Am J Med . 1976;;61:849-861.
4 +
Howard MW, Strauss RG, Johnston RB.  Infections in patients with neutropenia . AJDC . 1977;;131:788-790.
5 +
Ducos R, Madyastha PR, Warrier RP, Glassman AB, Shirley LR.  Neutrophil agglutinins in idiopathic chronic neutropenia of early childhood . AJDC . 1986;;140:65-68.
6 +
Conway LT, Clay ME, Kline WE, et al.  Natural history of primary autoimmune neutropenia in infancy . Pediatrics . 1987;;79:728-733.
7 +
Bodey GP, Budkley M, Sathe YS, et al.  Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia . Ann Intern Med . 1966;;64:328-340.
8 +
Wheetman RM, Boxer LA.  Childhood neutropenia . Pediatr Clin North Am . 1980;;27:361-375.
9 +
Hughes WT.  Neutropenia and fever . Pediatr Infect Dis . 1983;;2:514-516.
10 +
Boxer LA, McCallister JA.  The child with neutropenia . Pediatr Ann . 1979;;8:366-375.
11 +
Baehner RL, Boxer LA.  Disorders of granulopoiesis and granulocyte function . In: Nathan DG, Oski FA, eds. Hematology of Infancy and Childhood . Philadelphia, Pa: WB Saunders Co; 1981;:842-845.
12 +
Baehner RL.  Disorders of granulopoiesis . In: Miller DR, Pearson HA, Baehner RL, McMillan CW, eds. Smith's Blood Diseases of Infancy and Childhood . 4th ed. St Louis, Mo: CV Mosby Co; 1978;:512.
13 +
Fleiss JL. Statistical Methods for Rates and Proportions . New York, NY: John Wiley & Sons Inc; 1981;:143-146.
14 +
Bowden R, Hays T, Hathaway WE.  Neutropenia in the pediatric population and its association with infection . Pediatr Res . 1984;;18:236A.
15 +
Valiaveedan R, Rao S, Miller S, Brown A.  Transient neutropenia of childhood . Clin Pediatr . 1987;;26:639-642.
16 +
Fliedner TM, Cronkite EP, Robertson JS.  Granulocytopoiesis, I: senescence and random loss of neutrophilic granulocytes in human beings . Blood . 1964;;24:402.
17 +
Karayalcin G, Rosner F, Sawitsky A.  Pseudoneutropenia in Negroes: a normal phenomenon . NY State J Med . 1972;;72:1815-1817.
18 +
Caramihai E, Karayalcin G, Aballi AJ, Lanzkowsky P.  Leukocyte count differences in healthy white and black children 1 to 5 years of age . J Pediatr . 1975;;86:252-254.
19 +
Lalezari P, Manoocheher K, Petrosova M.  Autoimmune neutropenia of infancy . J Pediatr . 1986;;209:764-769.
20 +
Pisciotta AV.  Immune and toxic mechanism in drug-induced granulocytosis . Semin Hematol . 1973;;10:279.
21 +
Weitzman SA, Stossel TP, Desmond M.  Drug induced immunological neutropenias . Lancet . 1978;;1:1068-1072.
22 +
Stossel TP.  Phagocytosis . N Engl J Med . 1974;;290:717-723, 774-780, 833-839.
23 +
Finch SC.  Neutrophil disorders: benign, quantitative abnormalities of neutrophils . In: Williams WJ, Beutler E, Erslev A, Lichtman MA, eds. Hematology . 3rd ed. New York, NY: McGraw-Hill International Book Co; 1983;:786.

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References

1 +
Feigin RD, Matson DO.  Opportunistic infections . In: Feigin RD, Cherry JD, eds. Textbook of Pediatric Infectious Diseases . 2nd ed. Philadelphia, Pa: WB Saunders Co; 1987;:1018.
2 +
Joshi JH, Schimpff SC.  Infections in the compromised host . In: Mandell GL, Douglas RG, Bennett JE, eds. Principles and Practice of Infectious Diseases . 2nd ed. New York, NY: John Wiley & Sons Inc; 1985;:1645-1646.
3 +
Pincus SH, Boxer LA, Stossel TP.  Chronic neutropenia in childhood . Am J Med . 1976;;61:849-861.
4 +
Howard MW, Strauss RG, Johnston RB.  Infections in patients with neutropenia . AJDC . 1977;;131:788-790.
5 +
Ducos R, Madyastha PR, Warrier RP, Glassman AB, Shirley LR.  Neutrophil agglutinins in idiopathic chronic neutropenia of early childhood . AJDC . 1986;;140:65-68.
6 +
Conway LT, Clay ME, Kline WE, et al.  Natural history of primary autoimmune neutropenia in infancy . Pediatrics . 1987;;79:728-733.
7 +
Bodey GP, Budkley M, Sathe YS, et al.  Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia . Ann Intern Med . 1966;;64:328-340.
8 +
Wheetman RM, Boxer LA.  Childhood neutropenia . Pediatr Clin North Am . 1980;;27:361-375.
9 +
Hughes WT.  Neutropenia and fever . Pediatr Infect Dis . 1983;;2:514-516.
10 +
Boxer LA, McCallister JA.  The child with neutropenia . Pediatr Ann . 1979;;8:366-375.
11 +
Baehner RL, Boxer LA.  Disorders of granulopoiesis and granulocyte function . In: Nathan DG, Oski FA, eds. Hematology of Infancy and Childhood . Philadelphia, Pa: WB Saunders Co; 1981;:842-845.
12 +
Baehner RL.  Disorders of granulopoiesis . In: Miller DR, Pearson HA, Baehner RL, McMillan CW, eds. Smith's Blood Diseases of Infancy and Childhood . 4th ed. St Louis, Mo: CV Mosby Co; 1978;:512.
13 +
Fleiss JL. Statistical Methods for Rates and Proportions . New York, NY: John Wiley & Sons Inc; 1981;:143-146.
14 +
Bowden R, Hays T, Hathaway WE.  Neutropenia in the pediatric population and its association with infection . Pediatr Res . 1984;;18:236A.
15 +
Valiaveedan R, Rao S, Miller S, Brown A.  Transient neutropenia of childhood . Clin Pediatr . 1987;;26:639-642.
16 +
Fliedner TM, Cronkite EP, Robertson JS.  Granulocytopoiesis, I: senescence and random loss of neutrophilic granulocytes in human beings . Blood . 1964;;24:402.
17 +
Karayalcin G, Rosner F, Sawitsky A.  Pseudoneutropenia in Negroes: a normal phenomenon . NY State J Med . 1972;;72:1815-1817.
18 +
Caramihai E, Karayalcin G, Aballi AJ, Lanzkowsky P.  Leukocyte count differences in healthy white and black children 1 to 5 years of age . J Pediatr . 1975;;86:252-254.
19 +
Lalezari P, Manoocheher K, Petrosova M.  Autoimmune neutropenia of infancy . J Pediatr . 1986;;209:764-769.
20 +
Pisciotta AV.  Immune and toxic mechanism in drug-induced granulocytosis . Semin Hematol . 1973;;10:279.
21 +
Weitzman SA, Stossel TP, Desmond M.  Drug induced immunological neutropenias . Lancet . 1978;;1:1068-1072.
22 +
Stossel TP.  Phagocytosis . N Engl J Med . 1974;;290:717-723, 774-780, 833-839.
23 +
Finch SC.  Neutrophil disorders: benign, quantitative abnormalities of neutrophils . In: Williams WJ, Beutler E, Erslev A, Lichtman MA, eds. Hematology . 3rd ed. New York, NY: McGraw-Hill International Book Co; 1983;:786.

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