Causes of acquired isolated neutropenia in adulthood: a single center study

Abstract

Aims: Neutropenia, associated with several hereditary and acquired causes, is detected in a significant portion of patients presenting to the hematology outpatient clinic today. We conducted this study since we failed to find any Turkish publication on acquired isolated neutropenia in adults. Methods: This retrospective study examined data belonging to patients aged 18 years and older who applied to the adult hematology outpatient clinic whose absolute neutrophil count (ANC) was below the normal reference values (? 1.5 x 109/L). Results: 103 adult patients, 93 women and 10 men, were included in the study. Our study detected the cause of acquired isolated neutropenia as chronic idiopathic neutropenia (CINA) in 39.8% (n=41) of patients, autoimmune diseases in 18.4% (n=19), drugs in 14.6% (n=15), folate deficiency in 13.6% (n=14), infection in 9.7% (n=10), and hematological malignancy in 2.9% (n=3) and cyclic neutropenia in 1% (n=1). 92 patients (89.3%) were found to display mild neutropenia while 9 (8.7%) displayed moderate neutropenia and 2 (2%) displayed severe neutropenia. Interestingly, folate deficiency was detected in 6 of 9 (66.7%) moderately neutropenic patients. Conclusion: In our study, CINA was determined as the most common cause of acquired isolated neutropenia in adults, while autoimmune neutropenia was the second most common. In addition, the detection of folate deficiency in 6 of 9 patients (66.7%) with moderate neutropenia and the fact that these patients were in the advanced age group [mean 68 (range 62-81)] was a major finding of the study.