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Erschienen in:
12.08.2022 | Commentaries
Neutropenia: diagnosis and management
Erschienen in: World Journal of Pediatrics | Ausgabe 11/2022
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Neutropenia is defined as an absolute neutrophil count (ANC) of less than 1500/μL. According to the number of circulating neutrophils, neutropenia is divided into mild (1000/μL ≤ ANC < 1500/μL), moderate (500/μL ≤ ANC < 1000/μL), and severe (ANC < 500/μL) [1]. The etiology of neutropenia is shown in Table 1. The most common causes of neutropenia are pathogen infections. Other causes include immune disorders, malignant diseases and other hematolohic diseases, malnutrition, and the use of drugs. Congenital neutropenia is relatively rare, with a prevalence of 3–8.5 cases per million [2]. Excluding these causes, neutropenia lasting for more than three months is known as chronic idiopathic neutropenia (CIN) [3].
Table 1
Etiology of neutropenia
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Reasons
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|
|---|---|
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Infections
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Bacterial infections: rickettsia, brucella, typhoid, tuberculosis, etc.
Viral infections: chickenpox virus, cytomegalovirus, measles virus, Epstein-Barr virus (EBV), parvovirus B19, etc.
Other infections: fungus, chlamydia, etc.
|
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Drugs
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Chemotherapeutic agents: cyclosporine, cyclophosphamide, decitabine, carboplatin, etc.
Other drugs: antibiotics, antithyroids;antipsychotics, anticonvulsant, antirheumatics, non-steroidal anti-inflammatory drugs, etc.
|
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Gene defects
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Severe congenital neutropenia, cyclic neutropenia, syndromic congenital neutropenia: Shwachman-bodian-Diamond syndrome, Chédiak-higashi syndrome, Barth syndrome, etc.
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Malignant diseases and other hematologic diseases
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Leukemia, myelodysplastic syndrome, thymic tumors, aplastic anemia, etc.
|
|
Immune diseases
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Systemic autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, etc.; alloimmune neutropenia; autoimmune neutropenia
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Other
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Ethnic benign neutropenia
Nutritional deficiencies: deficiencies of protein, vitamin B12, folic acid, etc.
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|
Idiopathic
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