267 The Clinical Importance Of Neutropenia In Hospitalized Pediatric Patients

Abstract

Background: Neutropenia is not a common finding in hospitalized pediatric patients. However, it causes a great concern to the treating physicians. The aim of this study was to evaluate the clinical characteristics of the neutropenic patients admitted in general pediatric ward and to identify the relationship of neutropenia with the hematologic parameters and the degree of inflammation. Methods: The admitted patients in general pediatric ward during a period of twelve months and having at least one blood count from the same coulter analyzer were included in the study. The patients with chronic illnesses were not included. The clinical characteristics, the complete blood count and the sedimentation rate (SR) were recorded. Results: 193/1547 (12.47%) patients were neutropenic.16.5% of the neutropenic patients were leukopenic and 2.5% were thrombocytopenic. Studying the hematologic parameters of neutropenic and non neutropenic patients, the following mean values ± standard deviation, p value were reported: WBC 6.66± 3 vs. 10.8± 2.9 cells/mm3, p<0.001, Absolute number of monocytes 480±0.5 vs. 614±0.5 cells/mm3, p<0.001, Hemoglobin 10.9±1.7 vs. 11.5±1.6 gr/dl, p<0.001, Platelet count 383±151x10 3 vs. 417±154x10 3 cells/mm3, p=0.005. The neutropenic patients had statistical significant higher mean SR (33.2±29 vs. 27±23 mmHg, p=0.001). Only 14.5% of the neutropenic patients and 18.6% of the non neutropenic ones had SR50 mmHg. The length of hospitalization was not statistical significant different between the two groups: neutropenic patients 6.7 ± 4 days vs. non neutropenic patients 6.3 ± 4.3 days, p=0.12. The most common final diagnoses of the neutropenic patients were: 35.2% viral infection, 16.5% occult bacteremia, 10.3% urinary track infection, 6.2% pneumonia, 6% non infectious etiology. None of the patients was diagnosed with malignancy. Conclusion: 1/10 hospitalized patients are neutropenic with a small percentage of them being leukopenic or thrombocytopenic as well. Although the number of neutrophils has some relationship with the degree of inflammation, this isn't clinical significant, since only a low percentage of the neutropenic patients has SR50. The other hematologic parameters are lower in the neutropenic patients, but without any clinical significant effect. Neutropenia doesn't affect the course of the underling illness since doesn't prolong the length of hospitalization. Malignancy is not a common cause of neutropenia. 3/4 of the neutropenic patients are diagnosed with infection.