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Neutropenia in children

Korean Journal of Pediatrics 2009;52(6):633-643.
Published online June 15, 2009.
Neutropenia in children
Eun Sun Yoo
Department of Pediatrics, Ewha Womans University School of Medicine, Mok-dong Hospital, Seoul, Korea
소아기 호중구 감소증
유은선
이화여자대학교 의학전문대학원 소아과학교실
Correspondence: 
Eun Sun Yoo, Email: eunsyoo@ewha.ac.kr
Abstract
Neutropenia is defined as an absolute neutrophil count (ANC) of <1,500/µL, and the severity of neutropenia generally can be graded as mild (1,000-1,500/µL), moderate (500-1,000/µL), or severe (<500/µL). This stratification aids in predicting the risk of pyogenic infection because the susceptibility to life-threatening infections is significantly increased in patients with prolonged episodes of severe neutropenia. Especially cancer-related neutropenia carry significant mortality. Neutropenia can develop under various conditions such as decreased bone marrow production, the sequestering of neutrophils, and increased destruction of neutrophils in the peripheral blood. Neutropenia is classified according to the etiology as congenital or acquired, with the latter further defined according to the etiology or pathology. The clinical result is increased risk for infection, which is directly proportional to the severity and duration of the neutropenia. The typical workup of neutropenia starts with a 6-week period in which complete blood counts are measured twice weekly to document the persistence of the neutropenia and whether a cyclic pattern is present. When persistent neutropenia is diagnosed and no spontaneous recovery occurs within 3 months, a more extensive evaluation is advised. Treatment is usually unnecessary for most patients with severe neutropenia, as the majority of patients have a good prognosis. However, for patients who have severe and frequent infections, treatment with filgrastim may prevent infectious complications and improve quality of life.
Key Words: Neutropenia, Diagnostic approach, Management


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